- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $3,979.84 / $13,200.00
| Facility | | $1,150.00 | $3,979.84 | $13,200.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,870.06 / $5,030.00 / $6,036.00
| Facility | 50 | $1,870.06 | $5,030.00 | $6,036.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,091.22 / $11,208.10 / $17,846.03
| Facility | | $7,091.22 | $11,208.10 | $17,846.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $797.69 / $1,258.20 / $7,992.00
| Facility | | $797.69 | $1,258.20 | $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 |