- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $963.69 / $5,294.27 / $10,560.73
| Facility | | $963.69 | $5,294.27 | $10,560.73 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $5,953.04 / $11,765.25 / $11,765.25
| Facility | 22 | $5,953.04 | $11,765.25 | $11,765.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,302.10 / $6,395.00 / $13,523.26
| Facility | | $3,302.10 | $6,395.00 | $13,523.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.92 / $1,895.78 / $2,581.96
| Facility | | $1,098.92 | $1,895.78 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,264.00 / $4,983.00 / $9,622.00
| Facility | | $2,264.00 | $4,983.00 | $9,622.00 |