- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.62 / $3,500.00 / $14,402.56
| Facility | | $653.62 | $3,500.00 | $14,402.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,508.48 / $7,508.48 / $7,508.48
| Facility | 50 | $7,508.48 | $7,508.48 | $7,508.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,953.00 / $9,015.00 / $25,750.00
| Facility | | $3,953.00 | $9,015.00 | $25,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.84 / $1,072.71 / $1,609.07
| Facility | | $759.84 | $1,072.71 | $1,609.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,594.87 / $3,594.87 / $3,594.87
| Facility | | $3,594.87 | $3,594.87 | $3,594.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |