- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Facility | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $6,309.57 / $14,454.40
| Facility | | $2,137.96 | $6,309.57 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,202.26 / $2,818.38
| Facility | | $741.31 | $1,202.26 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Facility | 62 | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $60.26 / $60.26 / $60.26
| Facility | AS | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,148.15 / $2,238.72
| Facility | | $912.01 | $1,148.15 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $524.81 / $1,148.15
| Facility | | $338.84 | $524.81 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $5,495.41 / $11,748.98
| Facility | | $1,096.48 | $5,495.41 | $11,748.98 |