- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $7,585.78 / $17,378.01
| Facility | | $1,819.70 | $7,585.78 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,548.13 / $12,022.64 / $26,302.68
| Facility | 22 | $3,548.13 | $12,022.64 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $6,025.60 / $6,025.60 / $6,025.60
| Facility | AS | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $8,709.64 / $18,620.87
| Facility | | $3,548.13 | $8,709.64 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,071.52 / $17,782.79
| Facility | | $537.03 | $1,071.52 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $1,230.27
| Facility | 22 | $1,230.27 | $1,230.27 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $102.33 / $102.33 / $102.33
| Facility | AS | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,943.28 / $18,197.01
| Facility | | $2,137.96 | $7,943.28 | $18,197.01 |