- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $4,466.84 / $9,772.37
| Facility | | $1,778.28 | $4,466.84 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,467.37 / $3,467.37 / $3,467.37
| Facility | 22 | $3,467.37 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $6,165.95 / $13,489.63
| Facility | | $1,318.26 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,348.96
| Facility | AS | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $831.76 / $912.01
| Facility | | $50.12 | $831.76 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,230.27 / $7,079.46
| Facility | | $501.19 | $1,230.27 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $5,888.44 / $15,488.17
| Facility | | $851.14 | $5,888.44 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,786.30 / $11,481.54
| Facility | | $2,570.40 | $4,786.30 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $6,165.95 / $13,489.63
| Facility | | $1,318.26 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,348.96
| Facility | AS | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,025.60 / $15,488.17
| Facility | | $1,698.24 | $6,025.60 | $15,488.17 |