- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,495.41 / $12,589.25
| Facility | | $1,000.00 | $5,495.41 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,548.13 / $9,120.11 / $15,488.17
| Facility | 50 | $3,548.13 | $9,120.11 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $8,317.64 / $16,218.10
| Facility | | $3,311.31 | $8,317.64 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,905.46 / $4,897.79
| Facility | | $1,071.52 | $1,905.46 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,288.25 / $1,288.25 / $1,288.25
| Facility | 22 | $1,288.25 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $107.15 / $107.15 / $107.15
| Facility | AS | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $5,011.87 / $12,022.64
| Facility | | $1,348.96 | $5,011.87 | $12,022.64 |