- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.26 / $3,531.05 / $7,602.00
| Facility | | $1,905.26 | $3,531.05 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.00 / $2,388.00 / $5,611.00
| Facility | | $1,375.00 | $2,388.00 | $5,611.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $24,748.16 / $25,365.12
| Facility | | $55.00 | $24,748.16 | $25,365.12 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,107.56 / $4,101.85 / $4,101.85
| Facility | 62 | $2,107.56 | $4,101.85 | $4,101.85 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $337.21 / $656.30 / $656.30
| Facility | AS | $337.21 | $656.30 | $656.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.00 / $2,512.00 / $4,626.00
| Facility | | $1,233.00 | $2,512.00 | $4,626.00 |