- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,495.41 / $11,481.54
| Facility | | $1,174.90 | $5,495.41 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $501.19 / $4,265.80
| Facility | | $323.59 | $501.19 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | 22 | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Facility | AS | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $20,417.38 / $33,113.11
| Facility | | $8,128.31 | $20,417.38 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $7,585.78 / $12,022.64
| Facility | | $2,290.87 | $7,585.78 | $12,022.64 |