- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $6,165.95 / $6,606.93
| Facility | | $1,096.48 | $6,165.95 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $15,488.17 / $29,512.09
| Facility | | $7,079.46 | $15,488.17 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $15,488.17 / $27,542.29 / $69,183.10
| Facility | 50 | $15,488.17 | $27,542.29 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,073.80 / $9,772.37
| Facility | | $2,884.03 | $4,073.80 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | 22 | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $199.53 / $199.53 / $199.53
| Facility | AS | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $3,981.07 / $7,762.47
| Facility | | $3,162.28 | $3,981.07 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,570.40 / $11,748.98
| Facility | | $1,412.54 | $2,570.40 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $16,595.87
| Facility | | $4,466.84 | $9,120.11 | $16,595.87 |