- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.44 / $1,350.00 / $7,968.00
| Facility | | $630.44 | $1,350.00 | $7,968.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,765.52 / $6,106.65 / $6,106.65
| Facility | 50 | $2,765.52 | $6,106.65 | $6,106.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.00 / $767.42 / $1,590.73
| Facility | | $546.00 | $767.42 | $1,590.73 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $819.00 / $1,151.13 / $2,386.10
| Facility | 50 | $819.00 | $1,151.13 | $2,386.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.00 / $9,541.00 / $14,589.00
| Facility | | $3,366.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,413.08 / $8,723.79 / $12,000.00
| Facility | | $2,413.08 | $8,723.79 | $12,000.00 |