- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.55 / $3,290.94 / $20,025.20
| Facility | | $744.55 | $3,290.94 | $20,025.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,445.82 / $12,197.67 / $25,424.06
| Facility | | $3,445.82 | $12,197.67 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $16,312.75 / $24,750.01 / $43,396.95
| Facility | 50 | $16,312.75 | $24,750.01 | $43,396.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,815.83 / $2,576.40 / $6,197.87
| Facility | | $1,815.83 | $2,576.40 | $6,197.87 |
- 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
- $1,650.75 / $2,355.44 / $4,880.21
| Facility | | $1,650.75 | $2,355.44 | $4,880.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $819.58 / $1,532.46 / $9,370.00
| Facility | | $819.58 | $1,532.46 | $9,370.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $192.60 / $192.60 / $760.09
| Facility | AS | $192.60 | $192.60 | $760.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $9,370.00 / $12,774.00
| Facility | | $5,577.00 | $9,370.00 | $12,774.00 |