- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.35 / $4,150.08 / $18,834.73
| Facility | | $609.35 | $4,150.08 | $18,834.73 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,211.76 / $11,211.76 / $11,211.76
| Facility | 50 | $11,211.76 | $11,211.76 | $11,211.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,513.00 / $11,018.00 / $19,482.00
| Facility | | $4,513.00 | $11,018.00 | $19,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.36 / $789.75 / $1,269.26
| Facility | | $599.36 | $789.75 | $1,269.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.23 / $1,201.00 / $2,258.41
| Facility | | $723.23 | $1,201.00 | $2,258.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $71.36 / $71.36 / $71.36
| Facility | AS | $71.36 | $71.36 | $71.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,029.00 / $7,830.00 / $11,284.00
| Facility | | $2,029.00 | $7,830.00 | $11,284.00 |