- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $5,431.00 / $10,707.00
| Facility | | $1,671.00 | $5,431.00 | $10,707.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,129.75 / $16,914.00 / $16,914.00
| Facility | 50 | $6,129.75 | $16,914.00 | $16,914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,598.50 / $10,860.55
| Facility | | $1,763.75 | $6,598.50 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,848.08 / $5,848.08 / $5,848.08
| Facility | | $5,848.08 | $5,848.08 | $5,848.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.03 / $802.74 / $9,383.00
| Facility | | $592.03 | $802.74 | $9,383.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,882.29 / $3,882.29 / $3,882.29
| Facility | 50 | $3,882.29 | $3,882.29 | $3,882.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |