- 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
- $15,856.25 / $22,987.11 / $40,340.87
| Facility | | $15,856.25 | $22,987.11 | $40,340.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,089.31 / $5,251.83 / $7,856.00
| Facility | | $3,089.31 | $5,251.83 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $9,961.85 / $9,961.85 / $9,961.85
| Facility | 62 | $9,961.85 | $9,961.85 | $9,961.85 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,593.90 / $1,593.90 / $1,593.90
| Facility | AS | $1,593.90 | $1,593.90 | $1,593.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,206.10 / $7,712.44 / $10,908.05
| Facility | | $6,206.10 | $7,712.44 | $10,908.05 |
- 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 |