- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $4,168.69 / $11,748.98
| Facility | | $467.74 | $4,168.69 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $5,623.41 / $5,623.41 / $5,623.41
| Facility | 62 | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $10,232.93 / $18,620.87
| Facility | | $4,570.88 | $10,232.93 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $933.25 / $16,982.44
| Facility | | $512.86 | $933.25 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $660.69 / $660.69 / $660.69
| Facility | 22 | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $346.74 / $346.74 / $346.74
| Facility | 62 | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Facility | AS | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $8,709.64 / $18,197.01
| Facility | | $2,818.38 | $8,709.64 | $18,197.01 |