- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $7,585.78 / $18,197.01
| Facility | | $4,677.35 | $7,585.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,495.41 / $8,912.51
| Facility | | $4,168.69 | $5,495.41 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $3,890.45 / $6,918.31
| Facility | | $1,174.90 | $3,890.45 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $112,201.85 / $112,201.85
| Facility | | $56.23 | $112,201.85 | $112,201.85 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $70,794.58 / $70,794.58 / $70,794.58
| Facility | 62 | $70,794.58 | $70,794.58 | $70,794.58 |