- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $7,762.47 / $15,488.17
| Facility | | $933.25 | $7,762.47 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $13,803.84 / $26,915.35
| Facility | | $5,754.40 | $13,803.84 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,388.44 / $8,128.31
| Facility | | $2,398.83 | $3,388.44 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | 22 | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $165.96 / $165.96 / $165.96
| Facility | AS | $165.96 | $165.96 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,311.31 / $6,456.54
| Facility | | $2,630.27 | $3,311.31 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,235.94 / $12,589.25
| Facility | | $1,288.25 | $3,235.94 | $12,589.25 |
- 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 |