- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,709.13 / $6,528.28 / $41,761.00
| Facility | | $2,709.13 | $6,528.28 | $41,761.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $88,160.73 / $88,160.73 / $88,160.73
| Facility | 50 | $88,160.73 | $88,160.73 | $88,160.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,881.23 / $31,009.94 / $58,213.58
| Facility | | $22,881.23 | $31,009.94 | $58,213.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $529.40 / $880.63 / $35,725.01
| Facility | | $529.40 | $880.63 | $35,725.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $10,807.58 / $10,807.58 / $10,807.58
| Facility | AS | $10,807.58 | $10,807.58 | $10,807.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.09 / $1,187.03 / $38,194.64
| Facility | | $937.09 | $1,187.03 | $38,194.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,221.00 / $14,143.00 / $40,166.00
| Facility | | $11,221.00 | $14,143.00 | $40,166.00 |