- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,652.00 / $4,769.46 / $10,492.80
| Facility | | $2,652.00 | $4,769.46 | $10,492.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $2,226.00 / $4,147.00
| Facility | | $1,031.00 | $2,226.00 | $4,147.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $188,241.61 / $192,324.31
| Facility | | $55.00 | $188,241.61 | $192,324.31 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $7,406.61 / $16,234.19 / $16,234.19
| Facility | 62 | $7,406.61 | $16,234.19 | $16,234.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,397.00 / $4,544.00
| Facility | | $875.00 | $2,397.00 | $4,544.00 |