- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,344.23 / $4,897.79
| Facility | | $1,698.24 | $2,344.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,125.38 / $19,054.61
| Facility | | $6,456.54 | $14,125.38 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,548.82 / $1,737.80
| Facility | | $1,479.11 | $1,548.82 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,290.87 / $3,235.94
| Facility | | $1,584.89 | $2,290.87 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,235.94 / $3,235.94 / $3,235.94
| Facility | 22 | $3,235.94 | $3,235.94 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Facility | AS | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,623.41 / $12,022.64
| Facility | | $1,023.29 | $5,623.41 | $12,022.64 |