- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,071.52 / $14,125.38
| Facility | | $758.58 | $1,071.52 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $13,803.84 / $19,054.61
| Facility | | $6,456.54 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $707.95 / $794.33
| Facility | | $676.08 | $707.95 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,230.27 / $4,265.80
| Facility | | $870.96 | $1,230.27 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,479.11
| Facility | 22 | $1,479.11 | $1,479.11 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $123.03 / $123.03 / $123.03
| Facility | AS | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,762.47 / $10,964.78
| Facility | | $3,235.94 | $7,762.47 | $10,964.78 |