- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $4,677.35 / $11,748.98
| Facility | | $1,318.26 | $4,677.35 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $9,332.54 / $17,378.01
| Facility | | $3,388.44 | $9,332.54 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $2,089.30 / $5,623.41
| Facility | | $398.11 | $2,089.30 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $2,511.89
| Facility | 22 | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $1,659.59
| Facility | 52 | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | 53 | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Facility | AS | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,818.38 / $9,772.37
| Facility | | $537.03 | $2,818.38 | $9,772.37 |