- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $7,079.46 / $33,113.11
| Facility | | $3,548.13 | $7,079.46 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $19,952.62
| Facility | 22 | $19,952.62 | $19,952.62 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $16,218.10 / $27,542.29
| Facility | | $8,317.64 | $16,218.10 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,481.34 / $35,481.34 / $40,738.03
| Facility | | $35,481.34 | $35,481.34 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,471.29 / $16,218.10
| Facility | | $6,456.54 | $10,471.29 | $16,218.10 |