- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.24 / $2,006.00 / $10,635.00
| Facility | | $712.24 | $2,006.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $631.30 / $1,016.00 / $3,737.32
| Facility | 50 | $631.30 | $1,016.00 | $3,737.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,392.00 / $14,996.00
| Facility | | $1,712.00 | $3,392.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.55 / $832.13 / $978.98
| Facility | | $532.55 | $832.13 | $978.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,138.00 / $6,522.00
| Facility | | $2,233.00 | $4,138.00 | $6,522.00 |