- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $7,585.78 / $13,182.57
| Facility | | $5,248.07 | $7,585.78 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $11,481.54 / $26,302.68
| Facility | | $3,630.78 | $11,481.54 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,089.30 / $5,011.87
| Facility | | $1,318.26 | $2,089.30 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $1,230.27
| Facility | 22 | $1,230.27 | $1,230.27 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $102.33 / $102.33 / $102.33
| Facility | AS | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,995.26 / $3,981.07
| Facility | | $1,621.81 | $1,995.26 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,467.37 / $8,128.31
| Facility | | $724.44 | $3,467.37 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $9,332.54 / $13,182.57
| Facility | | $3,388.44 | $9,332.54 | $13,182.57 |