- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $792.77 / $5,273.51 / $8,094.98
| Facility | | $792.77 | $5,273.51 | $8,094.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,420.20 / $6,420.20 / $25,744.11
| Facility | 50 | $6,420.20 | $6,420.20 | $25,744.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.00 / $894.02 / $974.05
| Facility | | $804.00 | $894.02 | $974.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $861.14 / $861.14 / $861.14
| Facility | | $861.14 | $861.14 | $861.14 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.49 / $85.49 / $85.49
| Facility | AS | $85.49 | $85.49 | $85.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,021.12 / $9,021.12 / $12,273.27
| Facility | | $9,021.12 | $9,021.12 | $12,273.27 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,128.48 / $10,933.27 / $30,974.65
| Facility | 50 | $8,128.48 | $10,933.27 | $30,974.65 |