- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $5,495.41 / $14,454.40
| Facility | | $2,630.27 | $5,495.41 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,135.61 / $26,302.68
| Facility | | $10,715.19 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $8,128.31 / $12,882.50
| Facility | | $6,918.31 | $8,128.31 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,365.16 / $6,918.31
| Facility | | $2,691.53 | $4,365.16 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $5,248.07 / $13,182.57
| Facility | | $2,630.27 | $5,248.07 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,630.78 / $5,623.41 / $8,511.38
| Professional | | $3,630.78 | $5,623.41 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $27,542.29 / $27,542.29
| Facility | | $6,918.31 | $27,542.29 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $4,265.80 / $4,265.80 / $17,378.01
| Facility | 62 | $4,265.80 | $4,265.80 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,595.87
| Facility | | $7,585.78 | $12,302.69 | $16,595.87 |