- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $6,606.93 / $21,877.62
| Facility | | $1,905.46 | $6,606.93 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,862.09 / $11,220.18 / $38,904.51
| Facility | 22 | $1,862.09 | $11,220.18 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $25,118.86
| Facility | 62 | $2,818.38 | $2,818.38 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $6,456.54 / $6,456.54 / $6,456.54
| Facility | 80 | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $24,547.09 / $24,547.09 / $24,547.09
| Facility | AS | $24,547.09 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $16,218.10 / $35,481.34
| Facility | | $5,623.41 | $16,218.10 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $5,495.41 / $46,773.51
| Facility | | $1,659.59 | $5,495.41 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,467.37 / $3,467.37 / $3,467.37
| Facility | 22 | $3,467.37 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | 62 | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $288.40 / $288.40 / $288.40
| Facility | AS | $288.40 | $288.40 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $9,549.93 / $23,442.29
| Facility | | $2,951.21 | $9,549.93 | $23,442.29 |