- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,981.07 / $13,182.57
| Facility | | $1,000.00 | $3,981.07 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,715.19 / $10,715.19 / $10,715.19
| Facility | 50 | $10,715.19 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,120.11 / $14,454.40
| Facility | | $5,888.44 | $9,120.11 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $933.25 / $7,413.10
| Facility | | $616.60 | $933.25 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Facility | AS | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $4,265.80 / $8,317.64
| Facility | | $1,230.27 | $4,265.80 | $8,317.64 |