- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $2,691.53 / $6,456.54
| Facility | | $870.96 | $2,691.53 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $5,888.44 / $9,772.37
| Facility | | $1,737.80 | $5,888.44 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $524.81 / $1,096.48
| Facility | | $501.19 | $524.81 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | 22 | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $8,317.64 / $8,317.64
| Facility | | $54.95 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $4,466.84 / $7,585.78
| Facility | | $1,737.80 | $4,466.84 | $7,585.78 |