- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.46 / $3,246.65 / $17,945.00
| Facility | | $555.46 | $3,246.65 | $17,945.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,852.43 / $8,224.39 / $9,717.12
| Facility | 50 | $1,852.43 | $8,224.39 | $9,717.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,536.00 / $8,512.00 / $16,615.00
| Facility | | $3,536.00 | $8,512.00 | $16,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.90 / $913.50 / $1,370.25
| Facility | | $669.90 | $913.50 | $1,370.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,061.25 / $2,061.25 / $2,061.25
| Facility | | $2,061.25 | $2,061.25 | $2,061.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |