- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,760.83 / $14,791.08
| Facility | | $1,288.25 | $6,760.83 | $14,791.08 |
- 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
- $2,454.71 / $2,454.71 / $2,454.71
| Facility | 22 | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $204.17 / $204.17 / $204.17
| Facility | AS | $204.17 | $204.17 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $21,379.62 / $33,113.11
| Facility | | $9,332.54 | $21,379.62 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $5,128.61 / $10,715.19
| Facility | | $676.08 | $5,128.61 | $10,715.19 |