- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $4,440.25 / $7,439.00
| Facility | | $1,615.00 | $4,440.25 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,576.00 / $4,749.14 / $10,499.48
| Facility | | $3,576.00 | $4,749.14 | $10,499.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.00 / $4,086.00 / $7,778.00
| Facility | | $1,172.00 | $4,086.00 | $7,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $88,075.68 / $106,031.31
| Facility | | $55.00 | $88,075.68 | $106,031.31 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $6,285.42 / $13,302.56 / $13,302.56
| Facility | 62 | $6,285.42 | $13,302.56 | $13,302.56 |