- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $797.87 / $797.87 / $6,781.00
| Facility | | $797.87 | $797.87 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,395.25 / $11,395.25 / $11,395.25
| Facility | 50 | $11,395.25 | $11,395.25 | $11,395.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,258.37 / $31,774.48 / $66,228.75
| Facility | | $3,258.37 | $31,774.48 | $66,228.75 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $42,494.12 / $64,482.39 / $113,047.47
| Facility | 50 | $42,494.12 | $64,482.39 | $113,047.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,910.95 / $2,711.37 / $6,522.56
| Facility | | $1,910.95 | $2,711.37 | $6,522.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $90.07 / $90.07 / $90.07
| Facility | AS | $90.07 | $90.07 | $90.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.23 / $2,478.84 / $5,135.88
| Facility | | $1,737.23 | $2,478.84 | $5,135.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.73 / $1,596.33 / $10,884.00
| Facility | | $816.73 | $1,596.33 | $10,884.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,102.68 / $10,102.68 / $12,871.20
| Facility | 50 | $10,102.68 | $10,102.68 | $12,871.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $203.97 / $203.97 / $203.97
| Facility | AS | $203.97 | $203.97 | $203.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.00 / $11,496.00 / $21,528.00
| Facility | | $5,028.00 | $11,496.00 | $21,528.00 |