- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.90 / $5,536.94 / $27,163.81
| Facility | | $464.90 | $5,536.94 | $27,163.81 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,028.18 / $7,846.83 / $29,451.24
| Facility | 50 | $3,028.18 | $7,846.83 | $29,451.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,529.00 / $7,890.00 / $30,900.00
| Facility | | $3,529.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.97 / $682.73 / $1,032.69
| Facility | | $509.97 | $682.73 | $1,032.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $4,705.12
| Facility | | $4,705.12 | $4,705.12 | $4,705.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $10,000.00 / $15,750.00
| Facility | | $4,699.00 | $10,000.00 | $15,750.00 |