- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,424.50 / $24,233.27 / $46,874.97
| Facility | | $18,424.50 | $24,233.27 | $46,874.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,864.59 / $2,877.75 / $13,909.00
| Facility | | $1,864.59 | $2,877.75 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $4,716.47 / $4,716.47 / $4,716.47
| Facility | 62 | $4,716.47 | $4,716.47 | $4,716.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $754.64 / $754.64 / $754.64
| Facility | AS | $754.64 | $754.64 | $754.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,932.12 / $3,643.80 / $4,920.71
| Facility | | $2,932.12 | $3,643.80 | $4,920.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |