- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,265.80 / $10,964.78
| Facility | | $2,454.71 | $4,265.80 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,762.47 / $13,803.84
| Facility | | $3,890.45 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $4,570.88 / $37,153.52
| Facility | | $4,570.88 | $4,570.88 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $5,495.41 / $7,762.47
| Facility | | $34.67 | $5,495.41 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $3,467.37 / $3,467.37 / $3,467.37
| Facility | 62 | $3,467.37 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,677.35 / $11,748.98
| Facility | | $3,311.31 | $4,677.35 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $2,951.21
| Facility | | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $50,118.72 / $75,857.76
| Facility | | $2,511.89 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,073.80 / $9,120.11
| Facility | | $1,412.54 | $4,073.80 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,801.89 / $9,772.37
| Facility | | $2,570.40 | $3,801.89 | $9,772.37 |