- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,592.93 / $8,997.00 / $25,305.74
| Facility | | $1,592.93 | $8,997.00 | $25,305.74 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $4,986.01 / $4,986.01 / $4,986.01
| Facility | 22 | $4,986.01 | $4,986.01 | $4,986.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,185.00 / $10,766.00 / $60,320.00
| Facility | | $3,185.00 | $10,766.00 | $60,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $866.47 / $866.47 / $1,261.70
| Facility | | $866.47 | $866.47 | $1,261.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,304.75 / $15,412.70 / $67,623.17
| Facility | | $7,304.75 | $15,412.70 | $67,623.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,541.00 / $32,783.00 / $80,030.00
| Facility | | $9,541.00 | $32,783.00 | $80,030.00 |