- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $6,025.60 / $10,964.78
| Facility | | $1,148.15 | $6,025.60 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $501.19 / $4,168.69
| Facility | | $323.59 | $501.19 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $2,691.53
| Facility | 22 | $2,691.53 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $223.87 / $223.87 / $223.87
| Facility | AS | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $21,379.62 / $33,113.11
| Facility | | $9,332.54 | $21,379.62 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $5,011.87 / $10,715.19
| Facility | | $616.60 | $5,011.87 | $10,715.19 |