- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $6,456.54
| Facility | | $660.69 | $660.69 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $9,120.11 / $26,915.35
| Facility | | $5,754.40 | $9,120.11 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,187.76 / $5,248.07
| Facility | | $1,548.82 | $2,187.76 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $1,258.93
| Facility | 22 | $1,258.93 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,089.30 / $4,073.80
| Facility | | $1,698.24 | $2,089.30 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,659.59 / $9,332.54
| Facility | | $891.25 | $1,659.59 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $6,025.60 / $10,715.19
| Facility | | $3,019.95 | $6,025.60 | $10,715.19 |