- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,443.22 / $6,690.00 / $14,050.13
| Facility | | $1,443.22 | $6,690.00 | $14,050.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,259.31 / $12,495.40 / $31,087.11
| Facility | | $2,259.31 | $12,495.40 | $31,087.11 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $24,578.66 / $24,578.66 / $24,578.66
| Facility | 22 | $24,578.66 | $24,578.66 | $24,578.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,459.00 / $7,175.00 / $14,050.13
| Facility | | $1,459.00 | $7,175.00 | $14,050.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,295.22 / $1,295.22 / $1,331.92
| Facility | | $1,295.22 | $1,295.22 | $1,331.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,914.00 / $7,000.00
| Facility | | $2,332.00 | $3,914.00 | $7,000.00 |