- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,311.00 / $4,069.00 / $9,175.36
| Facility | | $2,311.00 | $4,069.00 | $9,175.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.00 / $2,387.00 / $4,827.00
| Facility | | $1,375.00 | $2,387.00 | $4,827.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $50,145.00 / $51,283.32
| Facility | | $55.00 | $50,145.00 | $51,283.32 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $5,577.09 / $11,142.67 / $11,142.67
| Facility | 62 | $5,577.09 | $11,142.67 | $11,142.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $2,665.00 / $4,918.00
| Facility | | $1,200.00 | $2,665.00 | $4,918.00 |