- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $5,370.32 / $15,488.17
| Facility | | $933.25 | $5,370.32 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,238.72 / $7,762.47 / $22,908.68
| Facility | 50 | $2,238.72 | $7,762.47 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $12,589.25 / $53,703.18
| Facility | | $3,090.30 | $12,589.25 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $128.82 / $128.82 / $128.82
| Facility | AS | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,302.69 / $20,417.38
| Facility | | $4,365.16 | $12,302.69 | $20,417.38 |