- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,818.38 / $7,943.28
| Facility | | $1,513.56 | $2,818.38 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $10,715.19 / $11,220.18
| Facility | | $5,888.44 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,187.76 / $2,884.03
| Facility | | $1,659.59 | $2,187.76 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $3,090.30 / $3,090.30
| Facility | | $34.67 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | 22 | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $1,949.84
| Facility | 62 | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Facility | AS | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $6,918.31 / $19,054.61
| Facility | | $1,318.26 | $6,918.31 | $19,054.61 |