- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.34 / $1,218.00 / $3,804.00
| Facility | | $535.34 | $1,218.00 | $3,804.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $731.75 / $731.75 / $827.00
| Facility | 50 | $731.75 | $731.75 | $827.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,044.39 / $6,044.39 / $7,253.27
| Facility | | $6,044.39 | $6,044.39 | $7,253.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,238.18 / $4,238.18 / $4,238.18
| Facility | | $4,238.18 | $4,238.18 | $4,238.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,565.00 / $2,828.00 / $6,992.00
| Facility | | $1,565.00 | $2,828.00 | $6,992.00 |