- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $10,964.78 / $23,988.33
| Facility | | $2,691.53 | $10,964.78 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $10,471.29 / $24,547.09
| Facility | | $2,570.40 | $10,471.29 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,698.24 / $2,137.96
| Facility | | $1,659.59 | $1,698.24 | $2,137.96 |
- 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
- $602.56 / $2,951.21 / $14,454.40
| Facility | | $602.56 | $2,951.21 | $14,454.40 |
- 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
- $1,288.25 / $7,585.78 / $13,489.63
| Facility | | $1,288.25 | $7,585.78 | $13,489.63 |