- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $4,897.79 / $8,511.38
| Facility | | $1,778.28 | $4,897.79 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $8,912.51
| Facility | | $2,238.72 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $2,511.89 / $11,481.54
| Facility | | $54.95 | $2,511.89 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,290.87 / $4,265.80 / $4,265.80
| Facility | 62 | $2,290.87 | $4,265.80 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $363.08 / $676.08 / $676.08
| Facility | AS | $363.08 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,818.38 / $10,471.29
| Facility | | $1,380.38 | $2,818.38 | $10,471.29 |