- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,344.23 / $4,897.79
| Facility | | $1,659.59 | $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
- $1,513.56 / $1,548.82 / $1,778.28
| Facility | | $1,513.56 | $1,548.82 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,691.53 / $2,691.53
| Facility | | $758.58 | $2,691.53 | $2,691.53 |
- 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 |