- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,127.17 / $11,002.72 / $18,205.80
| Facility | | $1,127.17 | $11,002.72 | $18,205.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,447.46 / $22,897.69 / $46,771.99
| Facility | | $5,447.46 | $22,897.69 | $46,771.99 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $30,010.15 / $45,531.96 / $79,836.27
| Facility | 50 | $30,010.15 | $45,531.96 | $79,836.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,734.26 / $3,879.52 / $9,332.71
| Facility | | $2,734.26 | $3,879.52 | $9,332.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $128.96 / $128.96 / $128.96
| Facility | AS | $128.96 | $128.96 | $128.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.69 / $3,546.82 / $7,348.60
| Facility | | $2,485.69 | $3,546.82 | $7,348.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,197.22 / $2,121.78 / $12,586.00
| Facility | | $1,197.22 | $2,121.78 | $12,586.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $291.30 / $291.30 / $291.30
| Facility | AS | $291.30 | $291.30 | $291.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,677.00 / $11,496.00 / $26,630.00
| Facility | | $5,677.00 | $11,496.00 | $26,630.00 |