- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $8,511.38 / $24,547.09
| Facility | | $1,412.54 | $8,511.38 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $18,620.87
| Facility | 22 | $18,620.87 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $10,000.00 / $30,199.52
| Facility | | $398.11 | $10,000.00 | $30,199.52 |
- 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
- $5,495.41 / $11,748.98 / $22,908.68
| Facility | | $5,495.41 | $11,748.98 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $11,748.98 / $18,620.87
| Facility | | $3,715.35 | $11,748.98 | $18,620.87 |