- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $952.71 / $2,292.00 / $9,504.00
| Facility | | $952.71 | $2,292.00 | $9,504.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,121.00 / $2,786.00 / $3,264.00
| Facility | | $1,121.00 | $2,786.00 | $3,264.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.26 / $872.71 / $1,090.89
| Facility | | $727.26 | $872.71 | $1,090.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $866.56 / $2,748.68 / $7,080.21
| Facility | | $866.56 | $2,748.68 | $7,080.21 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $531.50 / $531.50 / $531.50
| Facility | 62 | $531.50 | $531.50 | $531.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.04 / $85.04 / $85.04
| Facility | AS | $85.04 | $85.04 | $85.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.00 / $965.00 / $2,914.00
| Facility | | $444.00 | $965.00 | $2,914.00 |