- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $6,456.54 / $17,378.01
| Facility | | $1,071.52 | $6,456.54 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,332.54 / $30,199.52
| Facility | | $4,466.84 | $9,332.54 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $12,022.64 / $35,481.34
| Facility | | $758.58 | $12,022.64 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Facility | 22 | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $13,489.63 / $38,904.51
| Facility | | $3,801.89 | $13,489.63 | $38,904.51 |