- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $2,670.00 / $5,454.00
| Facility | | $1,485.00 | $2,670.00 | $5,454.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,791.00 / $1,791.00 / $16,990.66
| Facility | 50 | $1,791.00 | $1,791.00 | $16,990.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.10 / $4,983.00 / $8,723.79
| Facility | | $941.10 | $4,983.00 | $8,723.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.14 / $112.14 / $826.90
| Facility | AS | $112.14 | $112.14 | $826.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.10 / $953.42 / $6,679.00
| Facility | | $443.10 | $953.42 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $620.80 / $620.80 / $3,863.50
| Facility | | $620.80 | $620.80 | $3,863.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,402.00 / $9,401.00
| Facility | | $55.00 | $4,402.00 | $9,401.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.14 / $112.14 / $826.90
| Facility | AS | $112.14 | $112.14 | $826.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |