- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $6,329.00
| Facility | | $1,671.00 | $3,617.00 | $6,329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,750.01 / $6,436.80 / $10,528.19
| Facility | | $1,750.01 | $6,436.80 | $10,528.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.57 / $716.00 / $1,924.00
| Facility | | $398.57 | $716.00 | $1,924.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $632.28 / $632.28 / $1,174.16
| Facility | 62 | $632.28 | $632.28 | $1,174.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.00 / $1,535.00 / $2,175.00
| Facility | | $704.00 | $1,535.00 | $2,175.00 |