- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $839.75 / $4,933.00 / $8,596.94
| Facility | | $839.75 | $4,933.00 | $8,596.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,782.63 / $2,782.63 / $11,053.23
| Facility | 50 | $2,782.63 | $2,782.63 | $11,053.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,895.74 / $8,049.41 / $10,965.51
| Facility | | $6,895.74 | $8,049.41 | $10,965.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,971.29 / $5,639.19 / $7,434.91
| Facility | 50 | $3,971.29 | $5,639.19 | $7,434.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.25 / $4,933.00 / $8,596.94
| Facility | | $820.25 | $4,933.00 | $8,596.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,486.40 / $10,486.40 / $11,053.23
| Facility | 50 | $10,486.40 | $10,486.40 | $11,053.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,296.00 / $7,849.00 / $9,202.00
| Facility | | $3,296.00 | $7,849.00 | $9,202.00 |