- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.63 / $1,965.00 / $7,838.38
| Facility | | $283.63 | $1,965.00 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $491.25 / $4,448.80 / $4,448.80
| Facility | 50 | $491.25 | $4,448.80 | $4,448.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,691.63 / $6,202.85 / $10,107.45
| Facility | | $1,691.63 | $6,202.85 | $10,107.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.58 / $294.74 / $339.10
| Facility | | $159.58 | $294.74 | $339.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.00 / $1,158.00 / $1,401.00
| Facility | | $230.00 | $1,158.00 | $1,401.00 |