- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,100.08 / $54,638.00
| Facility | | $4,241.22 | $11,100.08 | $54,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,731.81 / $33,844.37 / $65,465.93
| Facility | | $25,731.81 | $33,844.37 | $65,465.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.01 / $747.96 / $1,878.65
| Facility | | $468.01 | $747.96 | $1,878.65 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,174.16 / $1,174.16 / $1,174.16
| Facility | 62 | $1,174.16 | $1,174.16 | $1,174.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.32 / $903.20 / $1,237.08
| Facility | | $735.32 | $903.20 | $1,237.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |