- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $5,370.32 / $11,481.54
| Facility | | $1,230.27 | $5,370.32 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $398.11 / $10,000.00
| Facility | | $34.67 | $398.11 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | 22 | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Facility | AS | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $23,442.29
| Facility | | $6,165.95 | $12,022.64 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $5,754.40 / $9,772.37
| Facility | | $1,905.46 | $5,754.40 | $9,772.37 |