- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,005.00 / $7,960.15
| Facility | | $1,671.00 | $4,005.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,945.50 / $4,945.50 / $4,945.50
| Facility | 50 | $4,945.50 | $4,945.50 | $4,945.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,106.86 / $5,113.62
| Facility | | $830.45 | $3,106.86 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,049.52 / $3,049.52 / $3,049.52
| Facility | | $3,049.52 | $3,049.52 | $3,049.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.61 / $616.85 / $3,787.00
| Facility | | $440.61 | $616.85 | $3,787.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $115.63 / $889.94 / $889.94
| Facility | AS | $115.63 | $889.94 | $889.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,140.00 / $3,592.00 / $5,546.00
| Facility | | $2,140.00 | $3,592.00 | $5,546.00 |