- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.84 / $1,251.21 / $2,290.19
| Facility | | $700.84 | $1,251.21 | $2,290.19 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,219.83 / $2,323.71 / $2,323.71
| Facility | 62 | $1,219.83 | $2,323.71 | $2,323.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $195.17 / $371.79 / $371.79
| Facility | AS | $195.17 | $371.79 | $371.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $929.31 / $1,787.47 / $2,509.07
| Facility | | $929.31 | $1,787.47 | $2,509.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |