- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.98 / $9,955.70 / $21,189.22
| Facility | | $1,093.98 | $9,955.70 | $21,189.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,255.57 / $16,192.78 / $36,581.76
| Facility | | $5,255.57 | $16,192.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,910.86 / $4,127.97 / $9,930.37
| Facility | | $2,910.86 | $4,127.97 | $9,930.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,366.32 / $3,773.95 / $7,819.20
| Facility | | $2,366.32 | $3,773.95 | $7,819.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,848.83 / $5,673.16 / $19,105.13
| Facility | | $1,848.83 | $5,673.16 | $19,105.13 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $12,096.92 / $12,096.92 / $12,096.92
| Facility | 22 | $12,096.92 | $12,096.92 | $12,096.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |