- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $971.01 / $7,097.08 / $15,300.00
| Facility | | $971.01 | $7,097.08 | $15,300.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,982.00 / $7,790.80 / $20,094.50
| Facility | 50 | $2,982.00 | $7,790.80 | $20,094.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,164.13 / $12,484.00 / $54,020.00
| Facility | | $3,164.13 | $12,484.00 | $54,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $12,742.00 / $23,031.00
| Facility | | $6,164.00 | $12,742.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,072.00 / $12,949.00 / $23,109.00
| Facility | | $4,072.00 | $12,949.00 | $23,109.00 |