- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.13 / $9,062.00 / $18,276.00
| Facility | | $588.13 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,054.29 / $5,391.80 / $9,227.19
| Facility | | $2,054.29 | $5,391.80 | $9,227.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $2,106.17 / $2,706.47
| Facility | | $715.00 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.00 / $555.33 / $1,000.49
| Facility | | $415.00 | $555.33 | $1,000.49 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $622.50 / $800.51 / $1,230.08
| Facility | 50 | $622.50 | $800.51 | $1,230.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $58.10 / $74.70 / $114.81
| Facility | AS | $58.10 | $74.70 | $114.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,764.00 / $10,147.00 / $16,816.00
| Facility | | $2,764.00 | $10,147.00 | $16,816.00 |