- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,235.94 / $10,471.29
| Facility | | $1,047.13 | $3,235.94 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $16,595.87 / $25,118.86
| Facility | | $8,709.64 | $16,595.87 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $8,912.51 / $8,912.51
| Facility | | $1,380.38 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $812.83 / $2,630.27
| Facility | | $489.78 | $812.83 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,162.28 / $3,162.28 / $3,162.28
| Facility | 22 | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | 62 | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | AS | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $6,456.54 / $14,791.08
| Facility | | $1,202.26 | $6,456.54 | $14,791.08 |