- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.41 / $1,319.90 / $9,757.32
| Facility | | $618.41 | $1,319.90 | $9,757.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $14,635.98 / $14,635.98 / $14,635.98
| Facility | 50 | $14,635.98 | $14,635.98 | $14,635.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,320.00 / $4,367.00 / $11,433.00
| Facility | | $2,320.00 | $4,367.00 | $11,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $673.47 / $964.61 / $1,112.75
| Facility | | $673.47 | $964.61 | $1,112.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.72 / $850.72 / $850.72
| Facility | | $850.72 | $850.72 | $850.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $84.26 / $84.26 / $84.26
| Facility | AS | $84.26 | $84.26 | $84.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.00 / $4,639.00 / $12,296.00
| Facility | | $973.00 | $4,639.00 | $12,296.00 |