- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.80 / $5,547.89 / $16,264.00
| Facility | | $1,252.80 | $5,547.89 | $16,264.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,648.60 / $7,051.23 / $16,207.50
| Facility | 50 | $3,648.60 | $7,051.23 | $16,207.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $2,673.72 / $3,183.00
| Facility | | $323.00 | $2,673.72 | $3,183.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,142.00 / $12,759.00 / $23,031.00
| Facility | | $6,142.00 | $12,759.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |