- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $589.47 / $4,846.00 / $14,063.00
| Facility | | $589.47 | $4,846.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,896.87 / $6,896.87 / $7,771.57
| Facility | 50 | $6,896.87 | $6,896.87 | $7,771.57 |
- 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
- $685.83 / $968.22 / $1,452.33
| Facility | | $685.83 | $968.22 | $1,452.33 |
- 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 |