- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,585.36 / $7,188.00 / $22,198.84
| Facility | | $1,585.36 | $7,188.00 | $22,198.84 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $27,071.92 / $27,071.92 / $27,071.92
| Facility | 22 | $27,071.92 | $27,071.92 | $27,071.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,710.05 / $24,945.35 / $36,649.28
| Facility | | $12,710.05 | $24,945.35 | $36,649.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,569.00 / $7,220.00 / $22,198.84
| Facility | | $1,569.00 | $7,220.00 | $22,198.84 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $27,071.92 / $27,071.92 / $27,071.92
| Facility | 22 | $27,071.92 | $27,071.92 | $27,071.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,443.40 / $1,443.40 / $1,602.09
| Facility | | $1,443.40 | $1,443.40 | $1,602.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,304.00 / $4,563.00 / $8,261.00
| Facility | | $2,304.00 | $4,563.00 | $8,261.00 |