- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,422.69 / $5,377.35 / $13,726.37
| Facility | | $1,422.69 | $5,377.35 | $13,726.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,475.15 / $10,475.15 / $10,800.75
| Facility | 50 | $10,475.15 | $10,475.15 | $10,800.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,583.00 / $9,198.00 / $21,481.00
| Facility | | $4,583.00 | $9,198.00 | $21,481.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,668.08 / $1,668.08 / $13,477.50
| Facility | | $1,668.08 | $1,668.08 | $13,477.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,340.32 / $1,340.32 / $13,296.25
| Facility | | $1,340.32 | $1,340.32 | $13,296.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $132.54 / $132.54 / $132.54
| Facility | AS | $132.54 | $132.54 | $132.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,488.00 / $3,174.86
| Facility | | $332.00 | $1,488.00 | $3,174.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,977.50 / $8,992.65 / $19,272.53
| Facility | | $2,977.50 | $8,992.65 | $19,272.53 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $14,524.24 / $14,524.24 / $14,524.24
| Facility | 50 | $14,524.24 | $14,524.24 | $14,524.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $1,340.32 / $23,610.00
| Facility | | $597.00 | $1,340.32 | $23,610.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $132.54 / $132.54 / $132.54
| Facility | AS | $132.54 | $132.54 | $132.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,337.00 / $6,450.00 / $13,665.00
| Facility | | $2,337.00 | $6,450.00 | $13,665.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,256.66 / $1,256.66 / $3,233.02
| Facility | | $1,256.66 | $1,256.66 | $3,233.02 |