- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $2,630.27
| Facility | | $501.19 | $501.19 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $40,738.03 / $97,723.72
| Facility | | $3,090.30 | $40,738.03 | $97,723.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $50,118.72 / $91,201.08 / $229,086.77
| Facility | 50 | $50,118.72 | $91,201.08 | $229,086.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,862.09 / $4,466.84
| Facility | | $1,318.26 | $1,862.09 | $4,466.84 |
- 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
- $1,412.54 / $1,778.28 / $3,467.37
| Facility | | $1,412.54 | $1,778.28 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,047.13 / $32,359.37
| Facility | | $630.96 | $1,047.13 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | 50 | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $15,135.61 / $77,624.71
| Facility | | $6,309.57 | $15,135.61 | $77,624.71 |