- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,683.00 / $8,400.00
| Facility | | $1,000.00 | $3,683.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,211.26 / $14,558.95 / $23,181.40
| Facility | | $9,211.26 | $14,558.95 | $23,181.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.47 / $1,379.24 / $10,198.00
| Facility | | $750.47 | $1,379.24 | $10,198.00 |
- 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
- $1,481.00 / $5,407.00 / $9,232.95
| Facility | | $1,481.00 | $5,407.00 | $9,232.95 |