- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $2,691.53 / $5,888.44
| Facility | | $933.25 | $2,691.53 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,370.32 / $7,585.78
| Facility | | $2,884.03 | $5,370.32 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $1,071.52 / $1,071.52
| Facility | | $39.81 | $1,071.52 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $812.83 / $1,995.26
| Facility | | $489.78 | $812.83 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | 22 | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $199.53 / $199.53 / $199.53
| Facility | AS | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,162.28 / $8,511.38
| Facility | | $912.01 | $3,162.28 | $8,511.38 |