- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $63,095.73 / $89,125.09
| Facility | | $1,778.28 | $63,095.73 | $89,125.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $2,290.87
| Facility | | $1,862.09 | $1,862.09 | $2,290.87 |
- 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
- $46,773.51 / $51,286.14 / $69,183.10
| Facility | | $46,773.51 | $51,286.14 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $4,466.84 / $6,165.95
| Facility | | $4,466.84 | $4,466.84 | $6,165.95 |