- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,097.36 / $3,104.00 / $6,329.00
| Facility | | $1,097.36 | $3,104.00 | $6,329.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,913.00 / $4,480.50 / $7,139.00
| Facility | 50 | $2,913.00 | $4,480.50 | $7,139.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,613.46 / $4,140.09
| Facility | | $672.35 | $2,613.46 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.37 / $648.70 / $7,920.00
| Facility | | $526.37 | $648.70 | $7,920.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,637.00 / $6,477.00 / $13,500.00
| Facility | | $4,637.00 | $6,477.00 | $13,500.00 |