- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,662.15 / $8,299.31 / $16,467.00
| Facility | | $3,662.15 | $8,299.31 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,171.67 / $2,171.67 / $2,171.67
| Facility | 62 | $2,171.67 | $2,171.67 | $2,171.67 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $347.47 / $347.47 / $347.47
| Facility | AS | $347.47 | $347.47 | $347.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,112.83 / $3,733.09 / $6,260.51
| Facility | | $3,112.83 | $3,733.09 | $6,260.51 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $671.20 / $730.80 / $1,126.33
| Facility | 80 | $671.20 | $730.80 | $1,126.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $469.84 / $511.56 / $788.43
| Facility | AS | $469.84 | $511.56 | $788.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |