- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,400.00 / $10,308.79 / $21,094.09
| Facility | | $1,400.00 | $10,308.79 | $21,094.09 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,309.69 / $10,309.69 / $16,387.31
| Facility | 50 | $10,309.69 | $10,309.69 | $16,387.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,092.59 / $1,473.23 / $1,800.61
| Facility | | $1,092.59 | $1,473.23 | $1,800.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.62 / $1,311.62 / $1,311.62
| Facility | | $1,311.62 | $1,311.62 | $1,311.62 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $130.15 / $130.15 / $130.15
| Facility | AS | $130.15 | $130.15 | $130.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,487.79 / $24,489.17 / $60,512.27
| Facility | | $17,487.79 | $24,489.17 | $60,512.27 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,295.62 / $23,640.52 / $121,687.14
| Facility | 50 | $10,295.62 | $23,640.52 | $121,687.14 |