- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,073.80 / $11,481.54
| Facility | | $2,344.23 | $4,073.80 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,481.54 / $19,054.61
| Facility | | $4,897.79 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $2,884.03 / $37,153.52
| Facility | | $2,884.03 | $2,884.03 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $3,548.13 / $50,118.72
| Facility | | $34.67 | $3,548.13 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $4,265.80 / $4,265.80 / $4,265.80
| Facility | 22 | $4,265.80 | $4,265.80 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Facility | AS | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $3,235.94 / $7,943.28
| Facility | | $2,187.76 | $3,235.94 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $50,118.72 / $75,857.76
| Facility | | $2,041.74 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,168.69 / $9,332.54
| Facility | | $1,513.56 | $4,168.69 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,344.23 / $7,943.28
| Facility | | $1,659.59 | $2,344.23 | $7,943.28 |