- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $7,244.36 / $26,302.68
| Facility | | $1,737.80 | $7,244.36 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $120,226.44 / $120,226.44 / $120,226.44
| Facility | 22 | $120,226.44 | $120,226.44 | $120,226.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $13,803.84 / $39,810.72
| Facility | | $4,677.35 | $13,803.84 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $22,387.21
| Facility | | $1,995.26 | $4,265.80 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $2,454.71
| Facility | 22 | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $22,908.68 / $77,624.71
| Facility | | $6,309.57 | $22,908.68 | $77,624.71 |