- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,182.00 / $7,960.15
| Facility | | $1,671.00 | $4,182.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,998.00 / $4,945.50 / $7,605.00
| Facility | 50 | $2,998.00 | $4,945.50 | $7,605.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,106.86 / $5,113.62
| Facility | | $830.45 | $3,106.86 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,833.49 / $2,833.49 / $2,833.49
| Facility | | $2,833.49 | $2,833.49 | $2,833.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.77 / $928.48 / $6,117.00
| Facility | | $684.77 | $928.48 | $6,117.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,596.86 / $5,596.86 / $5,596.86
| Facility | 50 | $5,596.86 | $5,596.86 | $5,596.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $4,545.00 / $7,217.00
| Facility | | $2,912.00 | $4,545.00 | $7,217.00 |