- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $795.77 / $4,933.00 / $11,866.00
| Facility | | $795.77 | $4,933.00 | $11,866.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,300.00 / $8,531.71 / $13,002.28
| Facility | 50 | $6,300.00 | $8,531.71 | $13,002.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,248.00 / $9,720.00 / $18,150.00
| Facility | | $4,248.00 | $9,720.00 | $18,150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,678.63 / $4,383.72 / $5,861.91
| Facility | | $3,678.63 | $4,383.72 | $5,861.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $8,220.00 / $15,090.00
| Facility | | $4,062.00 | $8,220.00 | $15,090.00 |