- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,950.40 / $15,835.24 / $52,385.26
| Facility | | $3,950.40 | $15,835.24 | $52,385.26 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $12,979.55 / $12,979.55 / $12,979.55
| Facility | 22 | $12,979.55 | $12,979.55 | $12,979.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $868.32 / $1,172.23 / $1,432.73
| Facility | | $868.32 | $1,172.23 | $1,432.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,038.28 / $1,038.28 / $1,038.28
| Facility | | $1,038.28 | $1,038.28 | $1,038.28 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $102.27 / $102.27 / $102.27
| Facility | AS | $102.27 | $102.27 | $102.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,001.93 / $32,973.56 / $53,013.22
| Facility | | $11,001.93 | $32,973.56 | $53,013.22 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $30,368.53 / $30,368.53 / $67,124.74
| Facility | 22 | $30,368.53 | $30,368.53 | $67,124.74 |