- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $26,915.35 / $56,234.13
| Facility | | $1,258.93 | $26,915.35 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,479.11
| Facility | | $1,174.90 | $1,174.90 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,905.46 / $1,905.46
| Facility | | $34.67 | $1,905.46 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | 22 | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $190.55 / $190.55 / $190.55
| Facility | AS | $190.55 | $190.55 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $28,183.83 / $48,977.88
| Facility | | $26,302.68 | $28,183.83 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $4,466.84 / $7,079.46
| Facility | | $4,466.84 | $4,466.84 | $7,079.46 |