- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,584.89 / $7,079.46
| Facility | | $1,584.89 | $1,584.89 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $25,703.96 / $58,884.37
| Facility | | $9,772.37 | $25,703.96 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $5,754.40 / $13,489.63
| Facility | | $4,073.80 | $5,754.40 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,311.31 / $3,311.31 / $3,311.31
| Facility | 22 | $3,311.31 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | 52 | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $275.42 / $275.42 / $275.42
| Facility | AS | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $5,495.41 / $10,715.19
| Facility | | $4,365.16 | $5,495.41 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $3,162.28 / $10,471.29
| Facility | | $1,621.81 | $3,162.28 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $7,943.28 / $26,302.68
| Facility | | $1,584.89 | $7,943.28 | $26,302.68 |