- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $6,918.31 / $15,488.17
| Facility | | $1,380.38 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,302.69 / $53,703.18
| Facility | | $4,466.84 | $12,302.69 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | 22 | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,302.69 / $18,620.87
| Facility | | $4,365.16 | $12,302.69 | $18,620.87 |