- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $6,918.31 / $17,378.01
| Facility | | $1,148.15 | $6,918.31 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | 62 | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $11,220.18 / $27,542.29
| Facility | | $4,073.80 | $11,220.18 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $2,238.72 / $7,762.47
| Facility | | $398.11 | $2,238.72 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,047.13 / $1,047.13 / $1,047.13
| Facility | 52 | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | 53 | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $812.83 / $812.83 / $812.83
| Facility | 62 | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $6,918.31 / $15,488.17
| Facility | | $1,778.28 | $6,918.31 | $15,488.17 |