- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $877.55 / $1,838.33 / $3,188.94
| Facility | | $877.55 | $1,838.33 | $3,188.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,453.14 / $9,612.60 / $31,819.96
| Facility | 50 | $9,453.14 | $9,612.60 | $31,819.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,296.85 / $3,296.85 / $3,296.85
| Facility | | $3,296.85 | $3,296.85 | $3,296.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,775.00 / $2,775.00 / $7,217.33
| Facility | | $2,775.00 | $2,775.00 | $7,217.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $985.00 / $3,428.00 / $9,302.00
| Facility | | $985.00 | $3,428.00 | $9,302.00 |