- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $2,238.72
| Facility | | $234.42 | $234.42 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $177.83 / $17,782.79
| Facility | | $154.88 | $177.83 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $851.14 / $2,041.74
| Facility | | $602.56 | $851.14 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $524.81 / $524.81 / $524.81
| Facility | 22 | $524.81 | $524.81 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $275.42 / $275.42 / $275.42
| Facility | 62 | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $43.65 / $43.65 / $43.65
| Facility | AS | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $831.76 / $1,621.81
| Facility | | $660.69 | $831.76 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $467.74 / $1,949.84
| Facility | | $257.04 | $467.74 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,862.09 / $3,467.37
| Facility | | $380.19 | $1,862.09 | $3,467.37 |