- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,370.32 / $12,882.50
| Facility | | $1,995.26 | $5,370.32 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,365.16 / $8,912.51 / $14,125.38
| Facility | 50 | $4,365.16 | $8,912.51 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $11,481.54 / $24,547.09
| Facility | | $3,630.78 | $11,481.54 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $6,918.31 / $19,054.61
| Facility | | $794.33 | $6,918.31 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | 22 | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,884.03 / $2,884.03 / $2,884.03
| Facility | 62 | $2,884.03 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $457.09 / $457.09 / $457.09
| Facility | AS | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,606.93 / $15,488.17
| Facility | | $2,290.87 | $6,606.93 | $15,488.17 |