- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $24,068.03
| Facility | | $4,241.22 | $10,431.19 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,693.37 / $22,623.81 / $42,470.67
| Facility | | $16,693.37 | $22,623.81 | $42,470.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,377.96 / $3,766.35 / $7,856.00
| Facility | | $2,377.96 | $3,766.35 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $6,964.51 / $6,964.51 / $6,964.51
| Facility | 62 | $6,964.51 | $6,964.51 | $6,964.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,114.32 / $1,114.32 / $1,114.32
| Facility | AS | $1,114.32 | $1,114.32 | $1,114.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,861.00 / $5,357.32 / $7,097.48
| Facility | | $3,861.00 | $5,357.32 | $7,097.48 |
- 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 |