- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $12,022.64 / $18,197.01
| Facility | | $870.96 | $12,022.64 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $24,547.09 / $58,884.37
| Facility | | $5,248.07 | $24,547.09 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,162.28 / $7,585.78
| Facility | | $2,238.72 | $3,162.28 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | 22 | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | AS | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,090.30 / $6,025.60
| Facility | | $2,454.71 | $3,090.30 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,778.28 / $12,022.64
| Facility | | $912.01 | $1,778.28 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $10,000.00 / $15,848.93
| Facility | | $5,495.41 | $10,000.00 | $15,848.93 |