- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $5,128.61 / $14,454.40
| Facility | | $1,096.48 | $5,128.61 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $41,686.94 / $41,686.94 / $41,686.94
| Facility | AS | $41,686.94 | $41,686.94 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $8,511.38 / $20,892.96
| Facility | | $3,162.28 | $8,511.38 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,949.84 / $6,606.93
| Facility | | $954.99 | $1,949.84 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,548.82 / $1,548.82 / $1,548.82
| Facility | 22 | $1,548.82 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $128.82 / $128.82 / $128.82
| Facility | AS | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $8,709.64 / $19,054.61
| Facility | | $3,019.95 | $8,709.64 | $19,054.61 |