- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $7,943.28 / $13,489.63
| Facility | | $3,388.44 | $7,943.28 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $19,498.45 / $38,018.94
| Facility | | $14,791.08 | $19,498.45 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,630.27 / $9,549.93
| Facility | | $1,513.56 | $2,630.27 | $9,549.93 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $3,162.28 / $3,890.45 / $5,370.32
| Professional | | $3,162.28 | $3,890.45 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $8,511.38 / $14,125.38
| Facility | | $7,079.46 | $8,511.38 | $14,125.38 |