- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,691.53 / $9,120.11
| Facility | | $501.19 | $2,691.53 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,778.28 / $1,862.09 / $1,862.09
| Facility | 22 | $1,778.28 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $8,709.64
| Facility | 62 | $2,818.38 | $2,818.38 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $10,715.19 / $20,417.38
| Facility | | $5,248.07 | $10,715.19 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $1,148.15 / $46,773.51
| Facility | | $457.09 | $1,148.15 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $812.83 / $812.83 / $812.83
| Facility | 22 | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | 62 | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $67.61 / $67.61 / $67.61
| Facility | AS | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $7,244.36 / $16,218.10
| Facility | | $2,238.72 | $7,244.36 | $16,218.10 |