- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,270.34 / $2,747.00 / $7,965.38
| Facility | | $1,270.34 | $2,747.00 | $7,965.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,886.00 / $4,290.81 / $24,575.04
| Facility | 50 | $2,886.00 | $4,290.81 | $24,575.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,939.00 / $6,109.74 / $16,742.00
| Facility | | $1,939.00 | $6,109.74 | $16,742.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $278.60 / $278.60 / $1,442.13
| Facility | AS | $278.60 | $278.60 | $1,442.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.25 / $1,909.00 / $6,679.00
| Facility | | $1,089.25 | $1,909.00 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,387.03 / $6,398.70 / $19,388.25
| Facility | | $4,387.03 | $6,398.70 | $19,388.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $6,280.00 / $26,542.00
| Facility | | $2,324.00 | $6,280.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $278.60 / $278.60 / $1,442.13
| Facility | AS | $278.60 | $278.60 | $1,442.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $5,097.00 / $10,764.00
| Facility | | $2,324.00 | $5,097.00 | $10,764.00 |