- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,915.56 / $21,899.37
| Facility | | $5,463.36 | $10,915.56 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,164.99 / $7,267.64 / $8,544.09
| Facility | 50 | $1,164.99 | $7,267.64 | $8,544.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,506.16 / $12,883.29 / $24,185.23
| Facility | | $9,506.16 | $12,883.29 | $24,185.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,159.28 / $2,619.52 / $25,755.39
| Facility | | $1,159.28 | $2,619.52 | $25,755.39 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,559.00 / $26,531.00 / $62,212.55
| Facility | 50 | $10,559.00 | $26,531.00 | $62,212.55 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,858.74 / $2,858.74 / $2,858.74
| Facility | AS | $2,858.74 | $2,858.74 | $2,858.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,127.05 / $3,189.35 / $10,543.81
| Facility | | $2,127.05 | $3,189.35 | $10,543.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |