- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,897.79 / $20,417.38
| Facility | | $2,089.30 | $4,897.79 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $8,709.64 / $14,454.40
| Facility | | $3,162.28 | $8,709.64 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $524.81 / $2,951.21
| Facility | | $501.19 | $524.81 | $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
- $8,511.38 / $8,511.38 / $23,442.29
| Facility | | $8,511.38 | $8,511.38 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | AS | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $7,413.10 / $14,454.40
| Facility | | $3,019.95 | $7,413.10 | $14,454.40 |