- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $7,762.47 / $8,912.51
| Facility | | $1,445.44 | $7,762.47 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $15,488.17 / $24,547.09
| Facility | | $5,248.07 | $15,488.17 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $3,467.37
| Facility | | $1,819.70 | $1,819.70 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,137.96 / $2,137.96 / $2,137.96
| Facility | 22 | $2,137.96 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Facility | AS | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,445.44 / $2,398.83
| Facility | | $1,023.29 | $1,445.44 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $8,912.51 / $25,703.96
| Facility | | $891.25 | $8,912.51 | $25,703.96 |