- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,921.80 / $10,419.34 / $20,154.36
| Facility | | $7,921.80 | $10,419.34 | $20,154.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,493.14 / $4,487.64 / $7,755.84
| Facility | | $2,493.14 | $4,487.64 | $7,755.84 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $4,307.78 / $7,694.91 / $7,694.91
| Facility | 62 | $4,307.78 | $7,694.91 | $7,694.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,254.74 / $6,199.09 / $8,345.79
| Facility | | $3,254.74 | $6,199.09 | $8,345.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,670.17 / $6,178.00 / $8,816.00
| Facility | | $1,670.17 | $6,178.00 | $8,816.00 |