- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,677.35 / $12,022.64
| Facility | | $1,000.00 | $4,677.35 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,691.53 / $6,606.93 / $16,218.10
| Facility | 50 | $2,691.53 | $6,606.93 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $8,511.38 / $17,378.01
| Facility | | $3,162.28 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,238.72 / $6,165.95
| Facility | | $1,122.02 | $2,238.72 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $1,445.44
| Facility | 22 | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,623.41 / $12,589.25
| Facility | | $1,995.26 | $5,623.41 | $12,589.25 |