- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $5,754.40 / $13,182.57
| Facility | | $2,187.76 | $5,754.40 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $11,481.54 / $22,387.21
| Facility | | $4,073.80 | $11,481.54 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $6,025.60 / $19,952.62
| Facility | | $426.58 | $6,025.60 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $7,244.36 / $7,244.36 / $7,244.36
| Facility | 22 | $7,244.36 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | 62 | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | AS | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,884.03 / $9,772.37
| Facility | | $537.03 | $2,884.03 | $9,772.37 |