- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $11,481.54 / $12,022.64
| Facility | | $1,288.25 | $11,481.54 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $13,803.84 / $29,512.09
| Facility | | $7,762.47 | $13,803.84 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,677.35 / $10,964.78
| Facility | | $3,311.31 | $4,677.35 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $2,691.53
| Facility | 22 | $2,691.53 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $223.87 / $223.87 / $223.87
| Facility | AS | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $4,466.84 / $8,709.64
| Facility | | $3,548.13 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,884.03 / $12,302.69
| Facility | | $1,659.59 | $2,884.03 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $14,791.08
| Facility | | $4,466.84 | $9,120.11 | $14,791.08 |