- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,570.40 / $6,606.93
| Facility | | $1,000.00 | $2,570.40 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $812.83 / $2,511.89 / $11,220.18
| Facility | 50 | $812.83 | $2,511.89 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $10,471.29 / $16,982.44
| Facility | | $6,760.83 | $10,471.29 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,981.07 / $10,964.78
| Facility | | $758.58 | $3,981.07 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,754.40 / $10,715.19
| Facility | | $1,621.81 | $5,754.40 | $10,715.19 |