- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $8,317.64 / $22,908.68
| Facility | | $1,698.24 | $8,317.64 | $22,908.68 |
- 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
- $1,513.56 / $1,862.09 / $2,630.27
| Facility | | $1,513.56 | $1,862.09 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,951.21 / $2,951.21
| Facility | | $34.67 | $2,951.21 | $2,951.21 |
- 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
- $851.14 / $2,570.40 / $15,135.61
| Facility | | $851.14 | $2,570.40 | $15,135.61 |