- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.64 / $5,324.00 / $11,996.00
| Facility | | $1,247.64 | $5,324.00 | $11,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $5,204.00 / $11,909.00
| Facility | | $3,283.00 | $5,204.00 | $11,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,449.35 / $1,449.35 / $37,499.62
| Facility | | $1,449.35 | $1,449.35 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.14 / $1,182.14 / $7,227.90
| Facility | | $1,182.14 | $1,182.14 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $735.39 / $735.39 / $735.39
| Facility | 62 | $735.39 | $735.39 | $735.39 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $117.66 / $117.66 / $117.66
| Facility | AS | $117.66 | $117.66 | $117.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $1,751.35 / $3,459.20
| Facility | | $319.00 | $1,751.35 | $3,459.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,692.17 / $4,692.17 / $7,916.86
| Facility | | $4,692.17 | $4,692.17 | $7,916.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $1,182.14 / $58,336.00
| Facility | | $597.00 | $1,182.14 | $58,336.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $735.39 / $735.39 / $735.39
| Facility | 62 | $735.39 | $735.39 | $735.39 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $117.66 / $117.66 / $117.66
| Facility | AS | $117.66 | $117.66 | $117.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,749.00 / $4,194.00 / $9,300.00
| Facility | | $1,749.00 | $4,194.00 | $9,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,193.51 / $1,193.51 / $4,201.59
| Facility | | $1,193.51 | $1,193.51 | $4,201.59 |