- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $8,128.31 / $26,915.35
| Facility | | $1,862.09 | $8,128.31 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $27,542.29 / $58,884.37
| Facility | | $11,481.54 | $27,542.29 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $6,760.83 / $15,848.93
| Facility | | $4,786.30 | $6,760.83 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | 22 | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $2,570.40
| Facility | 52 | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | AS | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $6,456.54 / $12,589.25
| Facility | | $5,128.61 | $6,456.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,715.35 / $11,481.54
| Facility | | $1,949.84 | $3,715.35 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $10,964.78 / $29,512.09
| Facility | | $1,584.89 | $10,964.78 | $29,512.09 |