- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,086.90 / $12,315.08 / $23,118.55
| Facility | | $9,086.90 | $12,315.08 | $23,118.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,534.90 / $2,373.35 / $7,856.00
| Facility | | $1,534.90 | $2,373.35 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $4,521.58 / $4,521.58 / $4,521.58
| Facility | 62 | $4,521.58 | $4,521.58 | $4,521.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,737.08 / $3,420.11 / $4,841.38
| Facility | | $2,737.08 | $3,420.11 | $4,841.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |