- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $5,623.41 / $13,803.84
| Facility | | $1,202.26 | $5,623.41 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $60,255.96 / $60,255.96 / $60,255.96
| Facility | 22 | $60,255.96 | $60,255.96 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $6,918.31 / $14,454.40
| Facility | | $2,630.27 | $6,918.31 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,412.54 / $5,011.87
| Facility | | $398.11 | $1,412.54 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $1,445.44
| Facility | 22 | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $120.23 / $120.23 / $120.23
| Facility | AS | $120.23 | $120.23 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $8,912.51 / $19,054.61
| Facility | | $2,884.03 | $8,912.51 | $19,054.61 |