- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,774.45 / $9,632.94 / $20,221.79
| Facility | | $4,774.45 | $9,632.94 | $20,221.79 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,790.50 / $3,790.50 / $3,790.50
| Facility | 22 | $3,790.50 | $3,790.50 | $3,790.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,718.25 / $13,170.73 / $24,724.83
| Facility | | $9,718.25 | $13,170.73 | $24,724.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.79 / $6,596.00 / $14,582.60
| Facility | | $1,247.79 | $6,596.00 | $14,582.60 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,736.48 / $2,632.21 / $2,632.21
| Facility | AS | $1,736.48 | $2,632.21 | $2,632.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,675.62 / $2,240.48 / $8,854.25
| Facility | | $1,675.62 | $2,240.48 | $8,854.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |