- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $255.48 / $4,470.00 / $12,154.00
| Facility | | $255.48 | $4,470.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,114.00 / $4,358.00 / $10,043.00
| Facility | | $2,114.00 | $4,358.00 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $523.38 / $6,335.00
| Facility | | $55.00 | $523.38 | $6,335.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $301.62 / $876.02 / $876.02
| Facility | 62 | $301.62 | $876.02 | $876.02 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $48.26 / $140.16 / $140.16
| Facility | AS | $48.26 | $140.16 | $140.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.00 / $3,233.00 / $11,343.00
| Facility | | $1,182.00 | $3,233.00 | $11,343.00 |