- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $7,054.73 / $13,396.00
| Facility | | $1,760.00 | $7,054.73 | $13,396.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,384.00 / $9,641.81 / $65,235.12
| Facility | 50 | $4,384.00 | $9,641.81 | $65,235.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,232.00 / $7,216.00 / $14,488.00
| Facility | | $2,232.00 | $7,216.00 | $14,488.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,710.00 / $17,537.00 / $22,145.00
| Facility | | $10,710.00 | $17,537.00 | $22,145.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $848.72 / $1,509.36 / $19,067.25
| Facility | | $848.72 | $1,509.36 | $19,067.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $227.67 / $227.67 / $1,887.52
| Facility | AS | $227.67 | $227.67 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,426.00 / $7,576.00 / $12,989.00
| Facility | | $2,426.00 | $7,576.00 | $12,989.00 |