- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,505.30 / $6,515.32 / $15,112.50
| Facility | | $1,505.30 | $6,515.32 | $15,112.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,008.69 / $9,733.50 / $25,473.84
| Facility | 50 | $4,008.69 | $9,733.50 | $25,473.84 |
- 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
- $1,541.26 / $2,390.00 / $10,957.50
| Facility | | $1,541.26 | $2,390.00 | $10,957.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.17 / $1,233.17 / $6,511.02
| Facility | | $1,233.17 | $1,233.17 | $6,511.02 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $122.40 / $122.40 / $122.40
| Facility | AS | $122.40 | $122.40 | $122.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,872.20 / $3,935.75
| Facility | | $332.00 | $1,872.20 | $3,935.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,277.00 / $6,802.95 / $19,321.39
| Facility | | $3,277.00 | $6,802.95 | $19,321.39 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,654.96 / $10,725.10 / $13,435.60
| Facility | 50 | $6,654.96 | $10,725.10 | $13,435.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $1,233.17 / $23,610.00
| Facility | | $597.00 | $1,233.17 | $23,610.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $122.40 / $122.40 / $122.40
| Facility | AS | $122.40 | $122.40 | $122.40 |
- 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
- $1,169.13 / $1,169.13 / $4,008.91
| Facility | | $1,169.13 | $1,169.13 | $4,008.91 |