- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $5,623.41 / $13,489.63
| Facility | | $1,737.80 | $5,623.41 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $20,417.38 / $20,417.38 / $20,417.38
| Facility | 62 | $20,417.38 | $20,417.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,302.69 / $33,113.11
| Facility | | $4,466.84 | $12,302.69 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $4,073.80 / $12,022.64
| Facility | | $398.11 | $4,073.80 | $12,022.64 |
- 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
- $1,584.89 / $1,584.89 / $1,584.89
| Facility | 62 | $1,584.89 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Facility | AS | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $10,232.93
| Facility | | $851.14 | $3,162.28 | $10,232.93 |