- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.86 / $5,192.00 / $13,719.80
| Facility | | $823.86 | $5,192.00 | $13,719.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $20,155.57 / $22,157.09 / $43,855.37
| Facility | 50 | $20,155.57 | $22,157.09 | $43,855.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,396.19 / $8,911.81 / $16,513.82
| Facility | | $2,396.19 | $8,911.81 | $16,513.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $3,413.02 / $4,385.79
| Facility | | $505.00 | $3,413.02 | $4,385.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.00 / $906.25 / $1,825.80
| Facility | | $404.00 | $906.25 | $1,825.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $606.00 / $1,422.08 / $2,734.40
| Facility | 50 | $606.00 | $1,422.08 | $2,734.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |