- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,299.94 / $1,299.94 / $7,859.00
| Facility | | $1,299.94 | $1,299.94 | $7,859.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,392.86 / $31,774.48 / $66,228.75
| Facility | | $6,392.86 | $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
- $3,142.55 / $4,458.83 / $10,726.31
| Facility | | $3,142.55 | $4,458.83 | $10,726.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $153.38 / $153.38 / $153.38
| Facility | AS | $153.38 | $153.38 | $153.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,856.86 / $4,076.44 / $8,445.91
| Facility | | $2,856.86 | $4,076.44 | $8,445.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,299.94 / $2,198.03 / $3,824.10
| Facility | | $1,299.94 | $2,198.03 | $3,824.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $336.38 / $336.38 / $336.38
| Facility | AS | $336.38 | $336.38 | $336.38 |
- 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 |