- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,107.52 / $6,975.82 / $16,467.00
| Facility | | $1,107.52 | $6,975.82 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,486.59 / $13,800.89 / $24,647.94
| Facility | 50 | $4,486.59 | $13,800.89 | $24,647.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,056.85 / $6,408.32 / $12,856.71
| Facility | | $2,056.85 | $6,408.32 | $12,856.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,413.02 / $3,413.02 / $4,385.79
| Facility | | $3,413.02 | $3,413.02 | $4,385.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $886.02 / $1,141.56 / $2,111.56
| Facility | | $886.02 | $1,141.56 | $2,111.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,329.03 / $1,494.80 / $2,591.13
| Facility | 50 | $1,329.03 | $1,494.80 | $2,591.13 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $177.20 / $199.31 / $345.48
| Facility | 80 | $177.20 | $199.31 | $345.48 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $124.04 / $139.51 / $241.84
| Facility | AS | $124.04 | $139.51 | $241.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |