- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,884.03 / $5,623.41
| Facility | | $1,513.56 | $2,884.03 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,778.28 / $16,982.44 / $16,982.44
| Facility | 50 | $1,778.28 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $5,011.87 / $9,332.54
| Facility | | $56.23 | $5,011.87 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $870.96 / $870.96 / $870.96
| Facility | AS | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $933.25 / $7,079.46
| Facility | | $436.52 | $933.25 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $3,890.45
| Facility | | $616.60 | $616.60 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $5,248.07 / $9,332.54
| Facility | | $56.23 | $5,248.07 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $870.96 / $870.96 / $870.96
| Facility | AS | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $11,220.18
| Facility | | $2,041.74 | $5,248.07 | $11,220.18 |