- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $992.96 / $5,296.01 / $19,601.91
| Facility | | $992.96 | $5,296.01 | $19,601.91 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,779.50 / $10,351.94 / $10,351.94
| Facility | 50 | $5,779.50 | $10,351.94 | $10,351.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.52 / $691.52 / $691.52
| Facility | | $691.52 | $691.52 | $691.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $69.08 / $69.08 / $69.08
| Facility | AS | $69.08 | $69.08 | $69.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,768.00 / $15,089.40 / $33,242.06
| Facility | | $5,768.00 | $15,089.40 | $33,242.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.00 / $4,854.00 / $15,806.54
| Facility | | $850.00 | $4,854.00 | $15,806.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,917.00 / $5,779.50 / $10,351.94
| Facility | 50 | $4,917.00 | $5,779.50 | $10,351.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.52 / $691.52 / $691.52
| Facility | | $691.52 | $691.52 | $691.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $69.08 / $69.08 / $69.08
| Facility | AS | $69.08 | $69.08 | $69.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.94 / $595.94 / $703.98
| Facility | | $595.94 | $595.94 | $703.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |