- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,344.34 / $5,796.00 / $12,592.00
| Facility | | $1,344.34 | $5,796.00 | $12,592.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,003.74 / $11,051.80 / $11,051.80
| Facility | 50 | $10,003.74 | $11,051.80 | $11,051.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,749.00 / $9,877.00 / $16,490.00
| Facility | | $4,749.00 | $9,877.00 | $16,490.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,484.29 / $2,644.00 / $12,319.50
| Facility | | $1,484.29 | $2,644.00 | $12,319.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.77 / $1,200.77 / $1,200.77
| Facility | | $1,200.77 | $1,200.77 | $1,200.77 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $119.08 / $119.08 / $119.08
| Facility | AS | $119.08 | $119.08 | $119.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,196.00 / $2,820.74
| Facility | | $332.00 | $1,196.00 | $2,820.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $995.24 / $995.24 / $995.24
| Facility | | $995.24 | $995.24 | $995.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,774.79 / $5,810.08 / $7,438.01
| Facility | | $2,774.79 | $5,810.08 | $7,438.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $1,200.77
| Facility | | $555.00 | $597.00 | $1,200.77 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $119.08 / $119.08 / $119.08
| Facility | AS | $119.08 | $119.08 | $119.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,341.00 / $6,700.00 / $16,903.00
| Facility | | $2,341.00 | $6,700.00 | $16,903.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,266.64 / $1,266.64 / $2,981.88
| Facility | | $1,266.64 | $1,266.64 | $2,981.88 |