- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $5,888.44 / $19,952.62
| Facility | | $1,584.89 | $5,888.44 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $5,754.40 / $8,511.38 / $8,511.38
| Facility | 62 | $5,754.40 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $14,454.40 / $28,840.32
| Facility | | $3,981.07 | $14,454.40 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $4,168.69 / $16,982.44
| Facility | | $630.96 | $4,168.69 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,090.30 / $3,090.30 / $3,090.30
| Facility | 22 | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | 62 | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | AS | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $12,022.64 / $34,673.69
| Facility | | $3,630.78 | $12,022.64 | $34,673.69 |