- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $906.96 / $5,350.41 / $14,827.01
| Facility | | $906.96 | $5,350.41 | $14,827.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,150.00 / $6,062.00 / $7,840.50
| Facility | 50 | $3,150.00 | $6,062.00 | $7,840.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,150.00 / $7,567.00 / $11,091.00
| Facility | | $4,150.00 | $7,567.00 | $11,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $950.00 / $2,409.53 / $4,747.66
| Facility | | $950.00 | $2,409.53 | $4,747.66 |
- 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
- $1,433.06 / $1,433.06 / $1,433.06
| Facility | | $1,433.06 | $1,433.06 | $1,433.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,911.77 / $7,345.15 / $11,901.64
| Facility | | $3,911.77 | $7,345.15 | $11,901.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.00 / $5,526.00 / $13,828.81
| Facility | | $926.00 | $5,526.00 | $13,828.81 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,150.00 / $6,062.00 / $7,840.50
| Facility | 50 | $3,150.00 | $6,062.00 | $7,840.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $623.70 / $623.70 / $623.70
| Facility | | $623.70 | $623.70 | $623.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.23 / $2,390.62 / $4,517.67
| Facility | | $723.23 | $2,390.62 | $4,517.67 |
- 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
- $569.51 / $621.15 / $621.15
| Facility | | $569.51 | $621.15 | $621.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,313.00 / $3,805.00 / $11,239.92
| Facility | | $1,313.00 | $3,805.00 | $11,239.92 |