- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,094.38 / $6,384.00 / $11,598.73
| Facility | | $1,094.38 | $6,384.00 | $11,598.73 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $14,498.06 / $14,498.06 / $14,498.06
| Facility | 22 | $14,498.06 | $14,498.06 | $14,498.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,297.06 / $2,297.06 / $2,330.58
| Facility | | $2,297.06 | $2,297.06 | $2,330.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.25 / $948.12 / $1,523.81
| Facility | | $674.25 | $948.12 | $1,523.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,226.93 / $4,226.93 / $4,226.93
| Facility | | $4,226.93 | $4,226.93 | $4,226.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,470.62 / $9,447.00 / $14,257.00
| Facility | | $2,470.62 | $9,447.00 | $14,257.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,236.75 / $8,957.00 / $33,500.00
| Facility | | $3,236.75 | $8,957.00 | $33,500.00 |