- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $7,079.46 / $19,952.62
| Facility | | $2,089.30 | $7,079.46 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $6,918.31 / $6,918.31 / $15,488.17
| Facility | 22 | $6,918.31 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,398.83 / $17,378.01 / $17,378.01
| Facility | 62 | $2,398.83 | $17,378.01 | $17,378.01 |
- 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
- $398.11 / $2,951.21 / $14,791.08
| Facility | | $398.11 | $2,951.21 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $3,548.13
| Facility | 22 | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | 62 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $295.12 / $295.12 / $295.12
| Facility | AS | $295.12 | $295.12 | $295.12 |
- 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 |