- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.93 / $5,766.00 / $10,011.00
| Facility | | $387.93 | $5,766.00 | $10,011.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,966.94 / $7,273.63 / $16,208.13
| Facility | | $2,966.94 | $7,273.63 | $16,208.13 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $16,526.08 / $16,526.08 / $16,526.08
| Facility | 22 | $16,526.08 | $16,526.08 | $16,526.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.44 / $5,281.00 / $10,097.25
| Facility | | $546.44 | $5,281.00 | $10,097.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.91 / $256.91 / $333.32
| Facility | | $256.91 | $256.91 | $333.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |