- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $8,709.64 / $52,480.75
| Facility | | $1,380.38 | $8,709.64 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $5,011.87 / $11,481.54 / $28,840.32
| Facility | 22 | $5,011.87 | $11,481.54 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $12,302.69 / $38,904.51
| Facility | | $5,370.32 | $12,302.69 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $15,135.61 / $89,125.09
| Facility | | $1,513.56 | $15,135.61 | $89,125.09 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | 22 | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $27,542.29 / $87,096.36
| Facility | | $6,760.83 | $27,542.29 | $87,096.36 |