- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $3,715.35 / $5,623.41
| Facility | | $2,691.53 | $3,715.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $2,818.38 / $43,651.58
| Facility | | $812.83 | $2,818.38 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | 62 | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | AS | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $741.31
| Facility | | $50.12 | $676.08 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $4,677.35 / $8,511.38
| Facility | | $302.00 | $4,677.35 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,454.71 / $4,677.35
| Facility | | $295.12 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $2,818.38 / $43,651.58
| Facility | | $812.83 | $2,818.38 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | 62 | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | AS | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $4,677.35
| Facility | | $794.33 | $2,754.23 | $4,677.35 |