- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.75 / $3,043.00 / $6,305.00
| Facility | | $760.75 | $3,043.00 | $6,305.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,445.50 / $2,987.00 / $5,751.00
| Facility | 50 | $1,445.50 | $2,987.00 | $5,751.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,515.38 / $4,140.09
| Facility | | $672.35 | $2,515.38 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,848.08 / $5,848.08 / $5,848.08
| Facility | | $5,848.08 | $5,848.08 | $5,848.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.80 / $1,023.48 / $9,383.00
| Facility | | $731.80 | $1,023.48 | $9,383.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,501.57 / $3,501.57 / $3,501.57
| Facility | 50 | $3,501.57 | $3,501.57 | $3,501.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $195.23 / $1,706.64 / $1,706.64
| Facility | AS | $195.23 | $1,706.64 | $1,706.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |