- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $4,073.80
| Facility | | $575.44 | $575.44 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $26,915.35 / $81,283.05
| Facility | | $15,135.61 | $26,915.35 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,949.84 / $4,677.35
| Facility | | $1,380.38 | $1,949.84 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $1,122.02
| Facility | 22 | $1,122.02 | $1,122.02 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,862.09 / $3,715.35
| Facility | | $1,513.56 | $1,862.09 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,621.81 / $27,542.29
| Facility | | $831.76 | $1,621.81 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $10,000.00 / $28,840.32
| Facility | | $1,584.89 | $10,000.00 | $28,840.32 |