- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $7,079.46 / $23,988.33
| Facility | | $616.60 | $7,079.46 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $5,623.41 / $5,623.41 / $5,623.41
| Facility | 62 | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $30,902.95 / $37,153.52
| Facility | | $10,471.29 | $30,902.95 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $14,125.38
| Facility | | $14,125.38 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,964.78 / $18,620.87
| Facility | | $7,244.36 | $10,964.78 | $18,620.87 |