- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $634.00 / $1,502.00 / $3,188.94
| Facility | | $634.00 | $1,502.00 | $3,188.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,118.50 / $2,118.50 / $15,675.70
| Facility | 50 | $2,118.50 | $2,118.50 | $15,675.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,483.31 / $3,483.31 / $3,483.31
| Facility | | $3,483.31 | $3,483.31 | $3,483.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.98 / $3,283.98 / $12,979.93
| Facility | | $3,283.98 | $3,283.98 | $12,979.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $4,797.00 / $10,455.00
| Facility | | $1,185.00 | $4,797.00 | $10,455.00 |