- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,018.00 / $5,982.00 / $10,257.00
| Facility | | $2,018.00 | $5,982.00 | $10,257.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,183.50 / $5,461.00 / $9,810.09
| Facility | 50 | $3,183.50 | $5,461.00 | $9,810.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $8,800.00 / $16,449.00
| Facility | | $3,400.00 | $8,800.00 | $16,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,794.98 / $12,794.98 / $30,237.02
| Facility | | $12,794.98 | $12,794.98 | $30,237.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,378.00 / $8,305.00 / $14,121.00
| Facility | | $5,378.00 | $8,305.00 | $14,121.00 |