- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,950.50 / $4,112.00 / $8,133.00
| Facility | | $1,950.50 | $4,112.00 | $8,133.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,048.19 / $9,469.49 / $15,661.28
| Facility | | $4,048.19 | $9,469.49 | $15,661.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,317.91 / $2,553.94 / $2,553.94
| Facility | | $2,317.91 | $2,553.94 | $2,553.94 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,572.60 / $1,572.60 / $1,572.60
| Facility | 62 | $1,572.60 | $1,572.60 | $1,572.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.50 / $4,044.50 / $8,138.00
| Facility | | $1,967.50 | $4,044.50 | $8,138.00 |