- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $512.86 / $4,570.88
| Facility | | $363.08 | $512.86 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $2,884.03 / $4,466.84
| Facility | | $1.00 | $2,884.03 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,318.26 / $3,162.28
| Facility | | $933.25 | $1,318.26 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $812.83 / $812.83 / $812.83
| Facility | 22 | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | 62 | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $67.61 / $67.61 / $67.61
| Facility | AS | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,258.93 / $2,454.71
| Facility | | $1,023.29 | $1,258.93 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $758.58 / $7,943.28
| Facility | | $363.08 | $758.58 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $5,495.41 / $11,748.98
| Facility | | $1,445.44 | $5,495.41 | $11,748.98 |