- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.22 / $2,056.00 / $5,643.46
| Facility | | $646.22 | $2,056.00 | $5,643.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,627.20 / $9,627.20 / $9,627.20
| Facility | 50 | $9,627.20 | $9,627.20 | $9,627.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,948.25 / $5,767.36 / $7,813.85
| Facility | | $4,948.25 | $5,767.36 | $7,813.85 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,105.68 / $3,617.94 / $5,023.00
| Facility | 50 | $3,105.68 | $3,617.94 | $5,023.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.69 / $2,056.00 / $5,643.46
| Facility | | $472.69 | $2,056.00 | $5,643.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,627.20 / $9,627.20 / $9,627.20
| Facility | 50 | $9,627.20 | $9,627.20 | $9,627.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,524.00 / $5,806.00 / $8,884.00
| Facility | | $2,524.00 | $5,806.00 | $8,884.00 |