- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $7,585.78 / $14,791.08
| Facility | | $1,047.13 | $7,585.78 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $13,803.84 / $32,359.37
| Facility | | $6,025.60 | $13,803.84 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $3,801.89 / $9,120.11
| Facility | | $3,019.95 | $3,801.89 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | 22 | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Facility | 62 | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $190.55 / $190.55 / $190.55
| Facility | AS | $190.55 | $190.55 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $4,265.80 / $7,244.36
| Facility | | $3,019.95 | $4,265.80 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,754.23 / $12,022.64
| Facility | | $1,148.15 | $2,754.23 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $9,332.54 / $13,182.57
| Facility | | $4,570.88 | $9,332.54 | $13,182.57 |