- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $7,413.10 / $17,378.01
| Facility | | $1,071.52 | $7,413.10 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $4,265.80 / $5,011.87 / $28,840.32
| Facility | 22 | $4,265.80 | $5,011.87 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,897.79 / $10,715.19 / $23,988.33
| Facility | 50 | $4,897.79 | $10,715.19 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.98 / $194.98 / $21,877.62
| Facility | AS | $194.98 | $194.98 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $9,772.37 / $20,417.38
| Facility | | $3,630.78 | $9,772.37 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,949.84 / $10,715.19
| Facility | | $891.25 | $1,949.84 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Facility | 22 | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $95.50 / $95.50 / $95.50
| Facility | AS | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,762.47 / $18,197.01
| Facility | | $2,137.96 | $7,762.47 | $18,197.01 |