- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $7,960.15
| Facility | | $1,671.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.40 / $3,100.51 / $5,432.89
| Facility | | $830.40 | $3,100.51 | $5,432.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.37 / $425.74 / $4,094.00
| Facility | | $330.37 | $425.74 | $4,094.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $535.89 / $992.48 / $992.48
| Facility | 62 | $535.89 | $992.48 | $992.48 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.74 / $158.80 / $158.80
| Facility | AS | $85.74 | $158.80 | $158.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $5,664.00 / $9,010.00
| Facility | | $1,424.00 | $5,664.00 | $9,010.00 |