- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,890.45 / $10,964.78
| Facility | | $1,096.48 | $3,890.45 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $6,309.57 / $14,125.38
| Facility | | $2,344.23 | $6,309.57 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,344.23 / $5,754.40
| Facility | | $1,122.02 | $2,344.23 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Facility | 62 | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $144.54 / $144.54 / $144.54
| Facility | AS | $144.54 | $144.54 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $7,244.36 / $17,378.01
| Facility | | $2,511.89 | $7,244.36 | $17,378.01 |