- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.17 / $1,399.00 / $3,536.33
| Facility | | $720.17 | $1,399.00 | $3,536.33 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $617.50 / $617.50 / $7,500.00
| Facility | 50 | $617.50 | $617.50 | $7,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,321.85 / $5,231.95 / $7,038.65
| Facility | | $4,321.85 | $5,231.95 | $7,038.65 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,482.78 / $7,847.92 / $10,557.97
| Facility | 50 | $6,482.78 | $7,847.92 | $10,557.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,125.00 / $5,085.00 / $9,624.00
| Facility | | $2,125.00 | $5,085.00 | $9,624.00 |