- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $6,025.60 / $13,803.84
| Facility | | $660.69 | $6,025.60 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $16,595.87 / $47,863.01
| Facility | | $3,162.28 | $16,595.87 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $588.84 / $588.84 / $588.84
| Facility | 22 | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $24,547.09 / $44,668.36
| Facility | | $14,125.38 | $24,547.09 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $10,471.29 / $37,153.52
| Facility | | $346.74 | $10,471.29 | $37,153.52 |