- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,856.02 / $4,474.00 / $7,960.15
| Facility | | $1,856.02 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,728.00 / $6,179.25 / $9,944.00
| Facility | 50 | $2,728.00 | $6,179.25 | $9,944.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.99 / $3,243.64 / $5,113.62
| Facility | | $849.99 | $3,243.64 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,941.68 / $4,941.68 / $4,941.68
| Facility | | $4,941.68 | $4,941.68 | $4,941.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $907.30 / $1,239.69 / $6,117.00
| Facility | | $907.30 | $1,239.69 | $6,117.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,929.20 / $2,929.20 / $2,929.20
| Facility | 50 | $2,929.20 | $2,929.20 | $2,929.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $238.29 / $1,442.13 / $1,442.13
| Facility | AS | $238.29 | $1,442.13 | $1,442.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $4,545.00 / $7,217.00
| Facility | | $2,912.00 | $4,545.00 | $7,217.00 |