- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $4,073.80 / $12,022.64
| Facility | | $912.01 | $4,073.80 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $15,488.17 / $19,054.61 / $89,125.09
| Facility | 50 | $15,488.17 | $19,054.61 | $89,125.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,079.46 / $41,686.94
| Facility | | $2,818.38 | $7,079.46 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,187.76 / $21,379.62
| Facility | | $891.25 | $2,187.76 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $89.13 / $89.13 / $89.13
| Facility | AS | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $17,782.79 / $50,118.72
| Facility | | $4,897.79 | $17,782.79 | $50,118.72 |