- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $2,818.38 / $10,471.29
| Facility | | $1,230.27 | $2,818.38 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $10,715.19 / $11,220.18
| Facility | | $9,332.54 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,621.81 / $2,089.30
| Facility | | $1,148.15 | $1,621.81 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,187.76 / $2,187.76
| Facility | | $34.67 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,630.27 / $2,630.27 / $2,630.27
| Facility | 22 | $2,630.27 | $2,630.27 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $218.78 / $218.78 / $218.78
| Facility | AS | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |