- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,196.00 / $3,813.10 / $7,602.00
| Facility | | $1,196.00 | $3,813.10 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,708.50 / $1,708.50 / $1,708.50
| Facility | 50 | $1,708.50 | $1,708.50 | $1,708.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,841.00 / $9,498.00 / $16,534.00
| Facility | | $3,841.00 | $9,498.00 | $16,534.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $86,081.45 / $86,081.45
| Facility | | $55.00 | $86,081.45 | $86,081.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $203.97 / $8,159.30 / $8,159.30
| Facility | AS | $203.97 | $8,159.30 | $8,159.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,052.00 / $10,986.00 / $19,168.00
| Facility | | $5,052.00 | $10,986.00 | $19,168.00 |