- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,897.79 / $12,022.64
| Facility | | $1,380.38 | $4,897.79 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $9,120.11 / $9,120.11 / $9,120.11
| Facility | 22 | $9,120.11 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $10,471.29 / $19,498.45
| Facility | | $3,467.37 | $10,471.29 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,819.70 / $8,317.64
| Facility | | $489.78 | $1,819.70 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | 22 | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,479.11
| Facility | 52 | $1,479.11 | $1,479.11 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Facility | AS | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $6,025.60 / $15,135.61
| Facility | | $1,380.38 | $6,025.60 | $15,135.61 |