- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,507.00 / $4,588.00 / $12,154.00
| Facility | | $2,507.00 | $4,588.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.00 / $4,490.00 / $14,717.03
| Facility | | $2,224.00 | $4,490.00 | $14,717.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $3,996.30 / $10,136.51
| Facility | | $1,120.00 | $3,996.30 | $10,136.51 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $5,004.00 / $9,516.21 / $9,516.21
| Facility | 62 | $5,004.00 | $9,516.21 | $9,516.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $3,233.00 / $11,343.00
| Facility | | $1,185.00 | $3,233.00 | $11,343.00 |