- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $6,760.83 / $14,125.38
| Facility | | $1,445.44 | $6,760.83 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $11,481.54 / $30,199.52
| Facility | | $398.11 | $11,481.54 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $7,244.36 / $7,244.36 / $7,244.36
| Facility | 22 | $7,244.36 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | 62 | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | AS | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $20,417.38 / $33,113.11
| Facility | | $7,943.28 | $20,417.38 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $5,011.87 / $10,715.19
| Facility | | $616.60 | $5,011.87 | $10,715.19 |