- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,306.00 / $2,747.00 / $5,048.00
| Facility | | $1,306.00 | $2,747.00 | $5,048.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,786.00 / $4,312.50 / $10,221.52
| Facility | 50 | $3,786.00 | $4,312.50 | $10,221.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,511.78 / $5,268.00 / $15,220.00
| Facility | | $1,511.78 | $5,268.00 | $15,220.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.21 / $1,458.32 / $6,679.00
| Facility | | $674.21 | $1,458.32 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.58 / $4,231.20 / $18,442.84
| Facility | | $1,191.58 | $4,231.20 | $18,442.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $6,104.00 / $26,542.00
| Facility | | $2,155.00 | $6,104.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |