- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $4,112.00 / $10,382.20
| Facility | | $1,392.00 | $4,112.00 | $10,382.20 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,151.00 / $5,083.63 / $10,965.00
| Facility | 50 | $2,151.00 | $5,083.63 | $10,965.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,221.62 / $11,214.31 / $17,622.49
| Facility | | $7,221.62 | $11,214.31 | $17,622.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $967.32 / $1,525.59 / $7,992.00
| Facility | | $967.32 | $1,525.59 | $7,992.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,442.13 / $1,442.13 / $1,442.13
| Facility | AS | $1,442.13 | $1,442.13 | $1,442.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,054.00 / $7,077.94
| Facility | | $1,157.00 | $4,054.00 | $7,077.94 |