- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,570.88 / $12,302.69
| Facility | | $1,023.29 | $4,570.88 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,137.96 / $7,585.78 / $20,417.38
| Facility | 50 | $2,137.96 | $7,585.78 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $7,762.47
| Facility | AS | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $10,232.93 / $21,877.62
| Facility | | $3,548.13 | $10,232.93 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,691.53 / $7,413.10
| Facility | | $1,348.96 | $2,691.53 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $134.90 / $134.90 / $134.90
| Facility | AS | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,754.40 / $14,125.38
| Facility | | $1,995.26 | $5,754.40 | $14,125.38 |