- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $5,011.87 / $12,022.64
| Facility | | $1,202.26 | $5,011.87 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $9,332.54 / $9,549.93
| Facility | | $691.83 | $9,332.54 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,137.96 / $2,137.96 / $2,137.96
| Facility | 22 | $2,137.96 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $177.83 / $177.83 / $177.83
| Facility | AS | $177.83 | $177.83 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,302.69 / $18,620.87
| Facility | | $4,365.16 | $12,302.69 | $18,620.87 |