- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $436.52 / $8,709.64
| Facility | | $371.54 | $436.52 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,388.44 / $5,623.41
| Facility | | $1,548.82 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $1,023.29
| Facility | | $457.09 | $457.09 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $549.54 / $549.54 / $549.54
| Facility | 22 | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $331.13 / $575.44
| Facility | | $245.47 | $331.13 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,467.37 / $8,317.64
| Facility | | $562.34 | $3,467.37 | $8,317.64 |