- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,019.95 / $8,511.38
| Facility | | $851.14 | $3,019.95 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $10,715.19 / $18,620.87
| Facility | | $9,332.54 | $10,715.19 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $4,677.35 / $5,623.41
| Facility | | $3,235.94 | $4,677.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $6,309.57 / $6,309.57
| Facility | | $34.67 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $3,981.07 / $3,981.07 / $3,981.07
| Facility | 62 | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,466.84 / $30,199.52
| Facility | | $602.56 | $4,466.84 | $30,199.52 |