- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,630.78 / $6,918.31
| Facility | | $2,137.96 | $3,630.78 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,412.54 / $4,265.80 / $10,000.00
| Facility | 50 | $1,412.54 | $4,265.80 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $6,918.31 / $30,199.52
| Facility | | $2,630.27 | $6,918.31 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $3,019.95 / $3,019.95 / $3,019.95
| Facility | AS | $3,019.95 | $3,019.95 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,995.26 / $7,079.46
| Facility | | $812.83 | $1,995.26 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,918.31 / $15,488.17
| Facility | | $2,570.40 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,090.30 / $10,964.78
| Facility | | $1,995.26 | $3,090.30 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $7,244.36 / $30,199.52
| Facility | | $2,754.23 | $7,244.36 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $3,019.95 / $3,019.95 / $3,019.95
| Facility | AS | $3,019.95 | $3,019.95 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $7,244.36 / $20,892.96
| Facility | | $2,570.40 | $7,244.36 | $20,892.96 |