- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $932.65 / $2,678.00 / $7,602.00
| Facility | | $932.65 | $2,678.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,543.00 / $8,430.00 / $14,914.00
| Facility | | $2,543.00 | $8,430.00 | $14,914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $12,880.67 / $13,231.24
| Facility | | $55.00 | $12,880.67 | $13,231.24 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,575.61 / $3,169.64 / $3,169.64
| Facility | 62 | $1,575.61 | $3,169.64 | $3,169.64 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $252.10 / $507.14 / $507.14
| Facility | AS | $252.10 | $507.14 | $507.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $2,665.00 / $4,918.00
| Facility | | $1,200.00 | $2,665.00 | $4,918.00 |