- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $3,548.13 / $7,413.10
| Facility | | $69.18 | $3,548.13 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $7,244.36 / $17,378.01
| Facility | | $1,023.29 | $7,244.36 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,258.93 / $3,019.95
| Facility | | $794.33 | $1,258.93 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | 22 | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,202.26 / $2,398.83
| Facility | | $977.24 | $1,202.26 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $630.96 / $3,715.35
| Facility | | $363.08 | $630.96 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,786.30 / $9,332.54
| Facility | | $1,659.59 | $4,786.30 | $9,332.54 |