- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $7,585.78 / $25,703.96
| Facility | | $512.86 | $7,585.78 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $9,332.54 / $22,387.21
| Facility | | $3,630.78 | $9,332.54 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,370.32 / $20,417.38 / $38,904.51
| Facility | 50 | $5,370.32 | $20,417.38 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,995.26 / $4,786.30
| Facility | | $1,258.93 | $1,995.26 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Facility | 22 | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $95.50 / $95.50 / $95.50
| Facility | AS | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $1,905.46 / $3,715.35
| Facility | | $1,548.82 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $954.99 / $9,332.54
| Facility | | $549.54 | $954.99 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,466.84 / $4,466.84 / $12,302.69
| Facility | 50 | $4,466.84 | $4,466.84 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $9,332.54 / $13,182.57
| Facility | | $3,388.44 | $9,332.54 | $13,182.57 |