- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,086.00 / $5,849.00 / $9,652.50
| Facility | | $2,086.00 | $5,849.00 | $9,652.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,657.25 / $9,196.00 / $13,794.00
| Facility | 50 | $5,657.25 | $9,196.00 | $13,794.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.57 / $3,840.73 / $5,814.97
| Facility | | $966.57 | $3,840.73 | $5,814.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,269.46 / $5,269.46 / $5,269.46
| Facility | | $5,269.46 | $5,269.46 | $5,269.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $621.41 / $865.58 / $9,383.00
| Facility | | $621.41 | $865.58 | $9,383.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,682.99 / $2,682.99 / $5,486.98
| Facility | 50 | $2,682.99 | $2,682.99 | $5,486.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $165.08 / $1,537.78 / $1,537.78
| Facility | AS | $165.08 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |