- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $9,549.93 / $28,183.83
| Facility | | $3,801.89 | $9,549.93 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | 62 | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $28,840.32 / $51,286.14
| Facility | | $8,912.51 | $28,840.32 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $25,118.86 / $26,915.35
| Facility | | $851.14 | $25,118.86 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $17,782.79 / $18,620.87
| Facility | | $17,782.79 | $17,782.79 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,890.45 / $5,754.40
| Facility | | $1,737.80 | $3,890.45 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,220.18 / $37,153.52
| Facility | | $7,244.36 | $11,220.18 | $37,153.52 |