- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.50 / $2,051.11 / $9,534.00
| Facility | | $617.50 | $2,051.11 | $9,534.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,011.70 / $4,026.94 / $36,242.76
| Facility | 50 | $4,011.70 | $4,026.94 | $36,242.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,934.00 / $14,996.00
| Facility | | $1,712.00 | $3,934.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.66 / $733.99 / $974.84
| Facility | | $611.66 | $733.99 | $974.84 |
- 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
- $2,840.00 / $5,998.00 / $7,847.00
| Facility | | $2,840.00 | $5,998.00 | $7,847.00 |