- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,791.68 / $8,674.09 / $16,467.00
| Facility | | $3,791.68 | $8,674.09 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- 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 / $3,222.93 / $6,445.86
| Facility | | $2,821.00 | $3,222.93 | $6,445.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |