- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,344.80 / $32,993.44 / $61,937.13
| Facility | | $24,344.80 | $32,993.44 | $61,937.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,192.82 / $7,127.79 / $10,344.70
| Facility | | $4,192.82 | $7,127.79 | $10,344.70 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $13,541.08 / $13,541.08 / $13,541.08
| Facility | 62 | $13,541.08 | $13,541.08 | $13,541.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,559.39 / $10,416.21 / $14,088.26
| Facility | | $6,559.39 | $10,416.21 | $14,088.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |