- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $11,481.54 / $43,651.58
| Facility | | $2,344.23 | $11,481.54 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $15,135.61 / $39,810.72
| Facility | | $398.11 | $15,135.61 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $3,548.13
| Facility | 22 | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $295.12 / $295.12 / $295.12
| Facility | AS | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $20,892.96 / $33,113.11
| Facility | | $9,120.11 | $20,892.96 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $11,220.18 / $18,620.87
| Facility | | $3,715.35 | $11,220.18 | $18,620.87 |