- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,630.58 / $8,876.00 / $25,825.24
| Facility | | $1,630.58 | $8,876.00 | $25,825.24 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,831.94 / $19,063.84 / $22,900.31
| Facility | 50 | $7,831.94 | $19,063.84 | $22,900.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,691.10 / $9,695.39 / $17,884.22
| Facility | | $3,691.10 | $9,695.39 | $17,884.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $580.00 / $5,740.31
| Facility | | $580.00 | $580.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.39 / $689.58 / $975.00
| Facility | | $522.39 | $689.58 | $975.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $792.06 / $1,108.05 / $1,462.50
| Facility | 50 | $792.06 | $1,108.05 | $1,462.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |