- 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
- $10,176.85 / $13,792.24 / $25,891.56
| Facility | | $10,176.85 | $13,792.24 | $25,891.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,487.02 / $2,342.62 / $7,856.00
| Facility | | $1,487.02 | $2,342.62 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $4,359.80 / $4,359.80 / $4,359.80
| Facility | 62 | $4,359.80 | $4,359.80 | $4,359.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,692.34 / $3,353.69 / $4,692.76
| Facility | | $2,692.34 | $3,353.69 | $4,692.76 |
- 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 |