- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,196.00 / $4,778.89 / $13,841.56
| Facility | | $2,196.00 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,501.19 / $11,521.30 / $21,628.42
| Facility | | $8,501.19 | $11,521.30 | $21,628.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.31 / $1,380.88 / $9,480.17
| Facility | | $830.31 | $1,380.88 | $9,480.17 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $10,381.59 / $10,381.59 / $10,381.59
| Facility | 62 | $10,381.59 | $10,381.59 | $10,381.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,661.06 / $1,661.06 / $1,661.06
| Facility | AS | $1,661.06 | $1,661.06 | $1,661.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,470.47 / $1,878.44 / $5,870.28
| Facility | | $1,470.47 | $1,878.44 | $5,870.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |