- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $9,549.93 / $38,018.94
| Facility | | $1,513.56 | $9,549.93 | $38,018.94 |
- 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
- $398.11 / $19,054.61 / $66,069.34
| Facility | | $398.11 | $19,054.61 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $2,454.71
| Facility | 22 | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | 52 | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $1,258.93
| Facility | 62 | $1,258.93 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $204.17 / $204.17 / $204.17
| Facility | AS | $204.17 | $204.17 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $15,135.61 / $27,542.29
| Facility | | $7,079.46 | $15,135.61 | $27,542.29 |