- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.40 / $12,146.56 / $24,046.72
| Facility | | $606.40 | $12,146.56 | $24,046.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,543.95 / $29,315.94 / $38,989.11
| Facility | 50 | $6,543.95 | $29,315.94 | $38,989.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,513.00 / $11,633.00 / $22,813.00
| Facility | | $4,513.00 | $11,633.00 | $22,813.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.91 / $707.46 / $1,137.00
| Facility | | $536.91 | $707.46 | $1,137.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.98 / $1,201.00 / $3,833.32
| Facility | | $643.98 | $1,201.00 | $3,833.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $63.83 / $63.83 / $63.83
| Facility | AS | $63.83 | $63.83 | $63.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $11,200.00 / $17,416.00
| Facility | | $3,300.00 | $11,200.00 | $17,416.00 |