- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.64 / $3,795.64 / $13,841.56
| Facility | | $221.64 | $3,795.64 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.64 / $376.79 / $3,379.46
| Facility | | $221.64 | $376.79 | $3,379.46 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $385.46 / $735.14 / $735.14
| Facility | 62 | $385.46 | $735.14 | $735.14 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $61.67 / $117.62 / $117.62
| Facility | AS | $61.67 | $117.62 | $117.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.08 / $565.49 / $794.64
| Facility | | $445.08 | $565.49 | $794.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |