- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,472.00 / $5,203.00
| Facility | | $900.00 | $2,472.00 | $5,203.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,161.50 / $13,686.00 / $13,686.00
| Facility | 50 | $11,161.50 | $13,686.00 | $13,686.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,108.12 / $5,829.08 / $8,467.35
| Facility | | $2,108.12 | $5,829.08 | $8,467.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.80 / $3,136.54 / $3,136.54
| Facility | | $592.80 | $3,136.54 | $3,136.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.23 / $1,424.00 / $2,334.89
| Facility | | $723.23 | $1,424.00 | $2,334.89 |
- 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
- $1,027.00 / $3,820.00 / $9,160.00
| Facility | | $1,027.00 | $3,820.00 | $9,160.00 |