- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $7,762.47 / $30,199.52
| Facility | | $1,412.54 | $7,762.47 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $12,302.69 / $53,703.18
| Facility | | $398.11 | $12,302.69 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $2,511.89
| Facility | 22 | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Facility | AS | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,302.69 / $18,620.87
| Facility | | $4,365.16 | $12,302.69 | $18,620.87 |