- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $4,897.79 / $10,964.78
| Facility | | $1,148.15 | $4,897.79 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $398.11 / $2,137.96
| Facility | | $34.67 | $398.11 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $2,570.40
| Facility | 22 | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $213.80 / $213.80 / $213.80
| Facility | AS | $213.80 | $213.80 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $20,892.96 / $33,113.11
| Facility | | $9,332.54 | $20,892.96 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,302.69 / $19,054.61
| Facility | | $4,365.16 | $12,302.69 | $19,054.61 |