- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $5,623.41 / $8,317.64
| Facility | | $1,122.02 | $5,623.41 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $977.24 / $3,090.30 / $13,182.57
| Facility | 50 | $977.24 | $3,090.30 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $33,113.11 / $79,432.82
| Facility | | $8,912.51 | $33,113.11 | $79,432.82 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $40,738.03 / $74,131.02 / $186,208.71
| Facility | 50 | $40,738.03 | $74,131.02 | $186,208.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $4,168.69 / $10,000.00
| Facility | | $2,951.21 | $4,168.69 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.98 / $194.98 / $194.98
| Facility | AS | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $4,073.80 / $7,943.28
| Facility | | $3,235.94 | $4,073.80 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,951.21 / $12,022.64
| Facility | | $1,584.89 | $2,951.21 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,290.87 / $4,677.35 / $14,125.38
| Facility | 50 | $2,290.87 | $4,677.35 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $10,000.00 / $34,673.69
| Facility | | $5,888.44 | $10,000.00 | $34,673.69 |