- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,321.49 / $4,264.00 / $10,527.00
| Facility | | $1,321.49 | $4,264.00 | $10,527.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,470.67 / $1,470.67 / $1,470.67
| Facility | | $1,470.67 | $1,470.67 | $1,470.67 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $913.41 / $913.41 / $913.41
| Facility | 62 | $913.41 | $913.41 | $913.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $146.15 / $146.15 / $146.15
| Facility | AS | $146.15 | $146.15 | $146.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,046.05 / $15,169.83 / $26,770.99
| Facility | | $6,046.05 | $15,169.83 | $26,770.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,161.22 / $5,424.00 / $10,527.00
| Facility | | $1,161.22 | $5,424.00 | $10,527.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,470.67 / $1,470.67 / $1,470.67
| Facility | | $1,470.67 | $1,470.67 | $1,470.67 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $913.41 / $913.41 / $913.41
| Facility | 62 | $913.41 | $913.41 | $913.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $146.15 / $146.15 / $146.15
| Facility | AS | $146.15 | $146.15 | $146.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,263.02 / $1,263.02 / $1,593.43
| Facility | | $1,263.02 | $1,263.02 | $1,593.43 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,510.78 / $1,510.78 / $1,510.78
| Facility | 62 | $1,510.78 | $1,510.78 | $1,510.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $7,000.00
| Facility | | $2,468.00 | $4,563.00 | $7,000.00 |