- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,897.79 / $10,964.78
| Facility | | $776.25 | $4,897.79 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $323.59 / $549.54
| Facility | | $34.67 | $323.59 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $660.69 / $660.69 / $660.69
| Facility | 22 | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $346.74 / $346.74 / $346.74
| Facility | 62 | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Facility | AS | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,238.72 / $4,786.30
| Facility | | $1,905.46 | $2,238.72 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,302.69 / $19,054.61
| Facility | | $4,365.16 | $12,302.69 | $19,054.61 |