- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $8,511.38 / $17,378.01
| Facility | | $1,862.09 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $12,589.25 / $16,218.10 / $20,892.96
| Facility | 50 | $12,589.25 | $16,218.10 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | AS | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $20,417.38 / $38,904.51
| Facility | | $14,125.38 | $20,417.38 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,011.87 / $15,848.93
| Facility | | $1,548.82 | $5,011.87 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,288.25 / $3,981.07
| Professional | | $891.25 | $1,288.25 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $13,803.84 / $22,387.21
| Facility | | $10,471.29 | $13,803.84 | $22,387.21 |