- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $6,456.54 / $17,378.01
| Facility | | $1,513.56 | $6,456.54 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $12,589.25 / $27,542.29
| Facility | | $4,570.88 | $12,589.25 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $15,488.17
| Facility | | $501.19 | $1,819.70 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | 22 | $2,187.76 | $2,187.76 | $2,187.76 |
- 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
- $2,137.96 / $8,317.64 / $19,054.61
| Facility | | $2,137.96 | $8,317.64 | $19,054.61 |