- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.12 / $4,421.35 / $11,576.00
| Facility | | $688.12 | $4,421.35 | $11,576.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,719.53 / $4,269.04 / $8,907.60
| Facility | 50 | $1,719.53 | $4,269.04 | $8,907.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.00 / $1,533.07 / $1,825.09
| Facility | | $611.00 | $1,533.07 | $1,825.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $12,767.00 / $23,031.00
| Facility | | $6,164.00 | $12,767.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |