- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $1,380.38 / $15,135.61
| Facility | | $478.63 | $1,380.38 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $18,197.01 / $26,302.68
| Facility | | $2,818.38 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $426.58 / $478.63
| Facility | | $407.38 | $426.58 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $724.44 / $3,630.78
| Facility | | $537.03 | $724.44 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $870.96 / $870.96 / $870.96
| Facility | 22 | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $6,025.60 / $10,715.19
| Facility | | $2,137.96 | $6,025.60 | $10,715.19 |