- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,022.00 / $6,614.00 / $16,097.00
| Facility | | $1,022.00 | $6,614.00 | $16,097.00 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,526.60 / $2,526.60 / $2,526.60
| Facility | 22 | $2,526.60 | $2,526.60 | $2,526.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $400.00 / $10,000.00
| Facility | | $323.00 | $400.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,624.00 / $21,162.00 / $32,051.00
| Facility | | $9,624.00 | $21,162.00 | $32,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |