- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $18,197.01 / $41,686.94
| Facility | | $6,918.31 | $18,197.01 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $22,387.21 / $29,512.09
| Facility | | $20,892.96 | $22,387.21 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $2,951.21
| Facility | | $691.83 | $691.83 | $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
- $6,918.31 / $24,547.09 / $47,863.01
| Facility | | $6,918.31 | $24,547.09 | $47,863.01 |