- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,797.00 / $6,954.00 / $13,200.00
| Facility | | $1,797.00 | $6,954.00 | $13,200.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,442.00 / $5,516.00 / $18,525.58
| Facility | 50 | $2,442.00 | $5,516.00 | $18,525.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,855.70 / $6,159.74 / $7,246.75
| Facility | | $2,855.70 | $6,159.74 | $7,246.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,517.00 / $12,517.00 / $12,517.00
| Facility | | $12,517.00 | $12,517.00 | $12,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $984.83 / $1,761.97 / $12,199.00
| Facility | | $984.83 | $1,761.97 | $12,199.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.00 / $4,960.00 / $11,732.00
| Facility | | $1,967.00 | $4,960.00 | $11,732.00 |