- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,951.21 / $10,964.78
| Facility | | $1,258.93 | $2,951.21 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $30,902.95 / $34,673.69
| Facility | | $5,888.44 | $30,902.95 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,445.44 / $1,862.09
| Facility | | $1,023.29 | $1,445.44 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,949.84 / $1,949.84
| Facility | | $34.67 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | 22 | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.98 / $194.98 / $194.98
| Facility | AS | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $6,760.83 / $35,481.34
| Facility | | $1,174.90 | $6,760.83 | $35,481.34 |