- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,890.45 / $8,511.38
| Facility | | $1,513.56 | $3,890.45 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,589.25 / $20,417.38
| Facility | | $8,128.31 | $12,589.25 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,290.87 / $11,481.54
| Facility | | $1,479.11 | $2,290.87 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $13,182.57 / $13,182.57 / $13,182.57
| Facility | 62 | $13,182.57 | $13,182.57 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,089.30 / $2,089.30 / $2,089.30
| Facility | AS | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $7,943.28 / $15,135.61
| Facility | | $1,949.84 | $7,943.28 | $15,135.61 |