- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.27 / $1,140.00 / $4,132.30
| Facility | | $470.27 | $1,140.00 | $4,132.30 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,910.59 / $2,910.59 / $37,005.91
| Facility | 50 | $2,910.59 | $2,910.59 | $37,005.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,644.37 / $3,644.37 / $3,644.37
| Facility | | $3,644.37 | $3,644.37 | $3,644.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,632.03 / $3,632.03 / $6,543.60
| Facility | | $3,632.03 | $3,632.03 | $6,543.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $985.00 / $3,572.00 / $9,302.00
| Facility | | $985.00 | $3,572.00 | $9,302.00 |