- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,995.26 / $6,606.93
| Facility | | $1,096.48 | $1,995.26 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $5,623.41 / $7,585.78
| Facility | | $4,677.35 | $5,623.41 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,079.46 / $8,317.64 / $11,220.18
| Facility | 50 | $7,079.46 | $8,317.64 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | 22 | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $229.09 / $229.09 / $229.09
| Facility | AS | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $4,265.80 / $7,244.36
| Facility | | $1,202.26 | $4,265.80 | $7,244.36 |