- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $829.00 / $5,882.51 / $11,550.00
| Facility | | $829.00 | $5,882.51 | $11,550.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,704.48 / $7,288.08 / $16,560.56
| Facility | 50 | $2,704.48 | $7,288.08 | $16,560.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.00 / $3,499.48 / $4,166.05
| Facility | | $494.00 | $3,499.48 | $4,166.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.00 / $12,759.00 / $23,031.00
| Facility | | $5,979.00 | $12,759.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,320.00 / $10,309.00 / $15,888.00
| Facility | | $3,320.00 | $10,309.00 | $15,888.00 |