- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $8,128.31
| Facility | | $794.33 | $794.33 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $40,738.03 / $97,723.72
| Facility | | $2,691.53 | $40,738.03 | $97,723.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,951.21 / $6,918.31
| Facility | | $2,089.30 | $2,951.21 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,737.80 / $1,737.80 / $1,737.80
| Facility | 22 | $1,737.80 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $144.54 / $144.54 / $144.54
| Facility | AS | $144.54 | $144.54 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,818.38 / $5,495.41
| Facility | | $2,238.72 | $2,818.38 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,621.81 / $12,589.25
| Facility | | $851.14 | $1,621.81 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $11,481.54 / $28,183.83
| Facility | | $4,786.30 | $11,481.54 | $28,183.83 |