- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.54 / $1,030.54 / $12,530.46
| Facility | | $1,030.54 | $1,030.54 | $12,530.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.63 / $12,197.67 / $25,424.06
| Facility | | $4,100.63 | $12,197.67 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $16,312.75 / $24,750.01 / $43,396.95
| Facility | 50 | $16,312.75 | $24,750.01 | $43,396.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,552.42 / $3,621.53 / $8,712.07
| Facility | | $2,552.42 | $3,621.53 | $8,712.07 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $124.52 / $124.52 / $124.52
| Facility | AS | $124.52 | $124.52 | $124.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,320.39 / $3,310.94 / $6,859.90
| Facility | | $2,320.39 | $3,310.94 | $6,859.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,099.58 / $1,834.18 / $9,370.00
| Facility | | $1,099.58 | $1,834.18 | $9,370.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $272.33 / $272.33 / $272.33
| Facility | AS | $272.33 | $272.33 | $272.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |