- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,857.00 / $7,562.14
| Facility | | $1,671.00 | $3,857.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,472.75 / $5,205.00 / $7,177.50
| Facility | 50 | $2,472.75 | $5,205.00 | $7,177.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,126.40 / $5,113.62
| Facility | | $830.45 | $3,126.40 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,833.49 / $2,833.49 / $2,833.49
| Facility | | $2,833.49 | $2,833.49 | $2,833.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.71 / $840.27 / $6,117.00
| Facility | | $645.71 | $840.27 | $6,117.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,980.28 / $3,980.28 / $3,980.28
| Facility | 50 | $3,980.28 | $3,980.28 | $3,980.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $4,545.00 / $7,217.00
| Facility | | $2,912.00 | $4,545.00 | $7,217.00 |