- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $4,590.00 / $14,100.00
| Facility | | $1,456.00 | $4,590.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,474.00 / $5,031.85 / $8,872.50
| Facility | 50 | $1,474.00 | $5,031.85 | $8,872.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,003.53 / $18,972.31 / $30,208.54
| Facility | | $12,003.53 | $18,972.31 | $30,208.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.69 / $2,318.12 / $14,587.03
| Facility | | $1,152.69 | $2,318.12 | $14,587.03 |
- 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
- $1,570.00 / $6,980.00 / $13,541.98
| Facility | | $1,570.00 | $6,980.00 | $13,541.98 |