- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,376.00 / $7,317.00 / $14,443.00
| Facility | | $1,376.00 | $7,317.00 | $14,443.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,836.84 / $7,276.77 / $13,498.00
| Facility | 50 | $2,836.84 | $7,276.77 | $13,498.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,300.14 / $12,484.00 / $54,020.00
| Facility | | $5,300.14 | $12,484.00 | $54,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.00 / $12,742.00 / $23,031.00
| Facility | | $5,979.00 | $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 |