- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,818.38 / $8,511.38
| Facility | | $851.14 | $2,818.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,715.19 / $11,220.18
| Facility | | $6,606.93 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,238.72 / $3,090.30
| Facility | | $1,819.70 | $2,238.72 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $3,548.13 / $3,548.13
| Facility | | $34.67 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $4,265.80 / $4,265.80 / $4,265.80
| Facility | 22 | $4,265.80 | $4,265.80 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Facility | AS | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $4,168.69 / $30,199.52
| Facility | | $407.38 | $4,168.69 | $30,199.52 |