- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $795.10 / $4,261.00 / $12,237.00
| Facility | | $795.10 | $4,261.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $611.57 / $2,183.50 / $3,589.50
| Facility | 50 | $611.57 | $2,183.50 | $3,589.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.00 / $4,643.00 / $17,951.00
| Facility | | $2,224.00 | $4,643.00 | $17,951.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,488.00 / $13,882.00 / $15,775.00
| Facility | | $7,488.00 | $13,882.00 | $15,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.14 / $1,174.17 / $12,067.29
| Facility | | $577.14 | $1,174.17 | $12,067.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,748.00 / $3,527.00 / $6,944.00
| Facility | | $1,748.00 | $3,527.00 | $6,944.00 |