- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.00 / $2,683.00 / $7,602.00
| Facility | | $1,821.00 | $2,683.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,417.00 / $2,345.00 / $4,147.00
| Facility | | $1,417.00 | $2,345.00 | $4,147.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $13,844.05 / $14,222.23
| Facility | | $55.00 | $13,844.05 | $14,222.23 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,684.61 / $3,388.65 / $3,388.65
| Facility | 62 | $1,684.61 | $3,388.65 | $3,388.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $2,665.00 / $4,918.00
| Facility | | $1,200.00 | $2,665.00 | $4,918.00 |