- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $3,981.07 / $14,454.40
| Facility | | $1,174.90 | $3,981.07 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,073.80 / $24,547.09
| Facility | | $2,398.83 | $4,073.80 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $27,542.29
| Facility | | $54.95 | $56.23 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | 62 | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,548.13 / $8,912.51
| Facility | | $1,071.52 | $3,548.13 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,754.23 / $5,370.32
| Facility | | $2,089.30 | $2,754.23 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,454.71 / $10,232.93
| Facility | | $436.52 | $2,454.71 | $10,232.93 |