- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $907.32 / $8,553.00 / $11,866.00
| Facility | | $907.32 | $8,553.00 | $11,866.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,713.80 / $13,083.00 / $16,807.50
| Facility | 50 | $4,713.80 | $13,083.00 | $16,807.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,142.00 / $9,287.00 / $36,529.00
| Facility | | $2,142.00 | $9,287.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.80 / $698.17 / $1,090.89
| Facility | | $581.80 | $698.17 | $1,090.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,959.64 / $2,959.64 / $2,959.64
| Facility | | $2,959.64 | $2,959.64 | $2,959.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,796.00 / $13,382.00
| Facility | | $4,070.00 | $8,796.00 | $13,382.00 |