- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,918.31 / $17,782.79
| Facility | | $1,698.24 | $6,918.31 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $7,079.46 / $9,772.37 / $9,772.37
| Facility | 22 | $7,079.46 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $9,120.11 / $18,197.01
| Facility | | $3,548.13 | $9,120.11 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $3,715.35 / $10,964.78
| Facility | | $549.54 | $3,715.35 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $2,691.53
| Facility | 22 | $2,691.53 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $223.87 / $223.87 / $223.87
| Facility | AS | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $7,244.36 / $16,218.10
| Facility | | $2,511.89 | $7,244.36 | $16,218.10 |