- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,507.18 / $3,792.26 / $8,113.00
| Facility | | $1,507.18 | $3,792.26 | $8,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,105.25 / $16,184.00 / $28,850.83
| Facility | | $8,105.25 | $16,184.00 | $28,850.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,733.58 / $1,733.58 / $2,416.05
| Facility | | $1,733.58 | $1,733.58 | $2,416.05 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,070.69 / $1,070.69 / $1,070.69
| Facility | 62 | $1,070.69 | $1,070.69 | $1,070.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.00 / $3,325.00 / $8,198.00
| Facility | | $1,403.00 | $3,325.00 | $8,198.00 |