- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $5,011.87
| Facility | | $724.44 | $724.44 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $38,904.51 / $91,201.08
| Facility | | $4,786.30 | $38,904.51 | $91,201.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,884.03 / $6,918.31
| Facility | | $2,041.74 | $2,884.03 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $1,659.59
| Facility | 22 | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $138.04 / $138.04 / $138.04
| Facility | AS | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,818.38 / $5,495.41
| Facility | | $2,238.72 | $2,818.38 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,137.96 / $13,182.57
| Facility | | $1,047.13 | $2,137.96 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $14,125.38 / $52,480.75
| Facility | | $6,760.83 | $14,125.38 | $52,480.75 |