- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $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
- $196.74 / $334.46 / $2,990.54
| Facility | | $196.74 | $334.46 | $2,990.54 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $342.53 / $650.92 / $650.92
| Facility | 62 | $342.53 | $650.92 | $650.92 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $54.80 / $104.15 / $104.15
| Facility | AS | $54.80 | $104.15 | $104.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.46 / $443.46 / $611.29
| Facility | | $395.46 | $443.46 | $611.29 |
- 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 |