- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $15,488.17
| Facility | | $691.83 | $691.83 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $7,413.10 / $16,982.44
| Facility | | $4,168.69 | $7,413.10 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,691.53 / $6,309.57
| Facility | | $1,659.59 | $2,691.53 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,584.89 / $1,584.89 / $1,584.89
| Facility | 22 | $1,584.89 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,047.13 / $1,047.13 / $1,047.13
| Facility | 52 | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $131.83 / $131.83 / $131.83
| Facility | AS | $131.83 | $131.83 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,570.40 / $5,011.87
| Facility | | $2,041.74 | $2,570.40 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,096.48 / $2,290.87
| Facility | | $724.44 | $1,096.48 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,365.16 / $10,000.00
| Facility | | $1,862.09 | $4,365.16 | $10,000.00 |