- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,524.93 / $8,477.27 / $20,928.72
| Facility | | $3,524.93 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,725.51 / $10,506.50 / $14,268.14
| Facility | 50 | $6,725.51 | $10,506.50 | $14,268.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,506.16 / $12,883.29 / $24,185.23
| Facility | | $9,506.16 | $12,883.29 | $24,185.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.93 / $1,890.12 / $10,471.25
| Facility | | $1,083.93 | $1,890.12 | $10,471.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,468.17 / $6,963.13 / $13,046.85
| Facility | 50 | $4,468.17 | $6,963.13 | $13,046.85 |
- 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
- $1,925.00 / $2,583.13 / $4,968.71
| Facility | | $1,925.00 | $2,583.13 | $4,968.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |