- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,313.83 / $2,894.76 / $7,088.73
| Facility | | $2,313.83 | $2,894.76 | $7,088.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.00 / $6,078.00 / $13,940.55
| Facility | | $2,089.00 | $6,078.00 | $13,940.55 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,968.08 / $1,968.08 / $11,796.97
| Facility | 62 | $1,968.08 | $1,968.08 | $11,796.97 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $314.89 / $314.89 / $1,887.52
| Facility | AS | $314.89 | $314.89 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $2,000.00 / $3,000.00
| Facility | | $2,000.00 | $2,000.00 | $3,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.47 / $2,060.37 / $6,679.00
| Facility | | $1,272.47 | $2,060.37 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,052.98 / $6,052.98 / $15,173.78
| Facility | | $6,052.98 | $6,052.98 | $15,173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $6,500.00 / $16,712.00
| Facility | | $2,386.00 | $6,500.00 | $16,712.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,968.08 / $1,968.08 / $11,796.97
| Facility | 62 | $1,968.08 | $1,968.08 | $11,796.97 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $314.89 / $314.89 / $1,887.52
| Facility | AS | $314.89 | $314.89 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $13,058.00
| Facility | | $2,386.00 | $5,904.00 | $13,058.00 |