- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,584.89 / $8,511.38
| Facility | | $851.14 | $1,584.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,715.19 / $15,135.61
| Facility | | $8,912.51 | $10,715.19 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,089.30 / $2,454.71
| Facility | | $1,445.44 | $2,089.30 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,630.27 / $2,818.38
| Facility | | $34.67 | $2,630.27 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,388.44 / $3,388.44 / $3,388.44
| Facility | 22 | $3,388.44 | $3,388.44 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $281.84 / $281.84 / $281.84
| Facility | AS | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $6,760.83 / $15,488.17
| Facility | | $1,174.90 | $6,760.83 | $15,488.17 |