- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $3,162.28 / $34,673.69
| Facility | | $1,174.90 | $3,162.28 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $11,748.98 / $93,325.43
| Facility | | $10,715.19 | $11,748.98 | $93,325.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,122.02 / $1,348.96
| Facility | | $794.33 | $1,122.02 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,513.56 / $1,513.56
| Facility | | $34.67 | $1,513.56 | $1,513.56 |
- 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
- $3,019.95 / $28,183.83 / $81,283.05
| Facility | | $3,019.95 | $28,183.83 | $81,283.05 |