- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.23 / $3,795.64 / $12,765.09
| Facility | | $622.23 | $3,795.64 | $12,765.09 |
- 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
- $622.23 / $1,120.01 / $8,163.00
| Facility | | $622.23 | $1,120.01 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,081.98 / $2,062.56 / $2,062.56
| Facility | 62 | $1,081.98 | $2,062.56 | $2,062.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $173.12 / $330.01 / $330.01
| Facility | AS | $173.12 | $330.01 | $330.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.24 / $1,586.59 / $2,237.92
| Facility | | $826.24 | $1,586.59 | $2,237.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |