- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.00 / $8,733.00 / $32,105.15
| Facility | | $1,548.00 | $8,733.00 | $32,105.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,138.22 / $9,144.00 / $15,622.14
| Facility | 50 | $6,138.22 | $9,144.00 | $15,622.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,793.00 / $10,734.00 / $31,393.00
| Facility | | $4,793.00 | $10,734.00 | $31,393.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,365.00 / $5,511.50 / $16,534.50
| Facility | | $1,365.00 | $5,511.50 | $16,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,043.79 / $22,413.00 / $27,004.00
| Facility | | $1,043.79 | $22,413.00 | $27,004.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $103.83 / $103.83 / $103.83
| Facility | AS | $103.83 | $103.83 | $103.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,826.00 / $28,546.00
| Facility | | $332.00 | $1,826.00 | $28,546.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $854.13 / $854.13 / $854.13
| Facility | | $854.13 | $854.13 | $854.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,175.78 / $9,449.20 / $12,004.29
| Facility | | $3,175.78 | $9,449.20 | $12,004.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,774.47 / $12,749.46 / $13,898.56
| Facility | 50 | $4,774.47 | $12,749.46 | $13,898.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $16,363.00 / $27,004.00
| Facility | | $555.00 | $16,363.00 | $27,004.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $103.83 / $103.83 / $103.83
| Facility | AS | $103.83 | $103.83 | $103.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,337.00 / $6,700.00 / $16,903.00
| Facility | | $2,337.00 | $6,700.00 | $16,903.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,534.68 / $1,534.68 / $4,053.84
| Facility | | $1,534.68 | $1,534.68 | $4,053.84 |