- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,705.95 / $7,409.08 / $23,164.42
| Facility | | $3,705.95 | $7,409.08 | $23,164.42 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $8,555.41 / $8,555.41 / $8,555.41
| Facility | 22 | $8,555.41 | $8,555.41 | $8,555.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,163.64 / $9,691.40 / $10,701.00
| Facility | 50 | $5,163.64 | $9,691.40 | $10,701.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.66 / $847.34 / $1,035.64
| Facility | | $627.66 | $847.34 | $1,035.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.90 / $746.90 / $746.90
| Facility | | $746.90 | $746.90 | $746.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $73.26 / $73.26 / $73.26
| Facility | AS | $73.26 | $73.26 | $73.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,362.80 / $14,180.70 / $27,699.35
| Facility | | $5,362.80 | $14,180.70 | $27,699.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,126.00 / $15,509.30 / $31,922.69
| Facility | 50 | $4,126.00 | $15,509.30 | $31,922.69 |