- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $7,079.46 / $19,952.62
| Facility | | $1,949.84 | $7,079.46 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,819.70 / $12,882.50 / $18,620.87
| Facility | 22 | $1,819.70 | $12,882.50 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $3,162.28 / $15,135.61 / $104,712.85
| Facility | 62 | $3,162.28 | $15,135.61 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $12,589.25 / $27,542.29
| Facility | | $4,677.35 | $12,589.25 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $2,630.27 / $14,791.08
| Facility | | $457.09 | $2,630.27 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,162.28 / $3,162.28 / $3,162.28
| Facility | 22 | $3,162.28 | $3,162.28 | $3,162.28 |
- 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
- $2,089.30 / $8,317.64 / $19,054.61
| Facility | | $2,089.30 | $8,317.64 | $19,054.61 |