- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.96 / $5,220.00 / $11,655.00
| Facility | | $694.96 | $5,220.00 | $11,655.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,100.00 / $6,079.77 / $29,149.45
| Facility | 50 | $2,100.00 | $6,079.77 | $29,149.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.00 / $2,673.72 / $3,183.00
| Facility | | $611.00 | $2,673.72 | $3,183.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.00 / $12,759.00 / $23,031.00
| Facility | | $5,979.00 | $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 |