- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $3,166.54 / $6,953.60
| Facility | | $1,615.00 | $3,166.54 | $6,953.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $518.28 / $35,600.00
| Facility | | $0.71 | $518.28 | $35,600.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,244.61 / $2,244.61 / $2,244.61
| Facility | 62 | $2,244.61 | $2,244.61 | $2,244.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,821.00 / $3,174.95 / $5,214.04
| Facility | | $2,821.00 | $3,174.95 | $5,214.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.00 / $661.00 / $4,877.00
| Facility | | $301.00 | $661.00 | $4,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $47,856.96 / $57,710.40
| Facility | | $55.00 | $47,856.96 | $57,710.40 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $4,453.45 / $9,562.91 / $9,562.91
| Facility | 62 | $4,453.45 | $9,562.91 | $9,562.91 |