- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $4,570.88 / $11,481.54
| Facility | | $1,148.15 | $4,570.88 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $10,964.78 / $22,387.21
| Facility | | $3,801.89 | $10,964.78 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $2,691.53 / $7,585.78
| Facility | | $549.54 | $2,691.53 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $1,202.26
| Facility | 62 | $1,202.26 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $10,232.93
| Facility | | $851.14 | $3,162.28 | $10,232.93 |