- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,630.78 / $12,022.64
| Facility | | $977.24 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,981.07 / $13,182.57
| Facility | | $2,344.23 | $3,981.07 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $1,905.46 / $1,949.84
| Facility | | $79.43 | $1,905.46 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $15,488.17
| Facility | | $1,995.26 | $1,995.26 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | 62 | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,570.40 / $5,248.07
| Facility | | $1,380.38 | $2,570.40 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,511.89 / $3,981.07
| Facility | | $1,949.84 | $2,511.89 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |