- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,041.74 / $7,762.47
| Facility | | $1,949.84 | $2,041.74 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $69,183.10 / $81,283.05
| Facility | | $56,234.13 | $69,183.10 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $2,238.72
| Facility | | $2,238.72 | $2,238.72 | $2,238.72 |
- 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
- $1,258.93 / $1,698.24 / $2,754.23
| Facility | | $1,258.93 | $1,698.24 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $5,011.87 / $17,782.79
| Facility | | $562.34 | $5,011.87 | $17,782.79 |