- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $1,880.36 / $22,252.94
| Facility | | $100.00 | $1,880.36 | $22,252.94 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $4,250.00 / $4,250.00 / $4,250.00
| Facility | 22 | $4,250.00 | $4,250.00 | $4,250.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,512.20 / $9,458.00 / $17,300.00
| Facility | | $8,512.20 | $9,458.00 | $17,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,906.58 / $3,906.58 / $4,043.31
| Facility | | $3,906.58 | $3,906.58 | $4,043.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,111.00 / $4,660.00 / $12,399.00
| Facility | | $1,111.00 | $4,660.00 | $12,399.00 |