- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $4,570.88 / $12,022.64
| Facility | | $1,318.26 | $4,570.88 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $10,715.19 / $20,892.96
| Facility | | $3,890.45 | $10,715.19 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $3,019.95 / $8,317.64
| Facility | | $398.11 | $3,019.95 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | 22 | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $10,232.93
| Facility | | $851.14 | $3,162.28 | $10,232.93 |