- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $8,128.31 / $9,120.11
| Facility | | $562.34 | $8,128.31 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,964.78 / $30,199.52
| Facility | | $8,912.51 | $10,964.78 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $380.19 / $426.58
| Facility | | $363.08 | $380.19 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $3,801.89
| Facility | | $660.69 | $660.69 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $794.33 / $794.33 / $794.33
| Facility | 22 | $794.33 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $66.07 / $66.07 / $66.07
| Facility | AS | $66.07 | $66.07 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $10,000.00 / $16,218.10
| Facility | | $2,511.89 | $10,000.00 | $16,218.10 |