- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,570.40 / $18,197.01
| Facility | | $1,318.26 | $2,570.40 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,737.80
| Facility | | $1,412.54 | $1,412.54 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,290.87 / $2,290.87
| Facility | | $34.67 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | 22 | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $229.09 / $229.09 / $229.09
| Facility | AS | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $20,417.38
| Facility | | $3,548.13 | $3,548.13 | $20,417.38 |