- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.64 / $3,401.00 / $11,481.00
| Facility | | $335.64 | $3,401.00 | $11,481.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $919.20 / $919.20 / $919.20
| Facility | 50 | $919.20 | $919.20 | $919.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.00 / $977.92 / $1,164.19
| Facility | | $494.00 | $977.92 | $1,164.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,144.00 / $5,731.00 / $11,037.00
| Facility | | $3,144.00 | $5,731.00 | $11,037.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.00 / $3,611.00 / $8,105.00
| Facility | | $1,014.00 | $3,611.00 | $8,105.00 |