- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.73 / $5,642.00 / $12,669.00
| Facility | | $883.73 | $5,642.00 | $12,669.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,953.87 / $6,698.16 / $21,789.58
| Facility | 50 | $2,953.87 | $6,698.16 | $21,789.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.00 / $2,673.72 / $3,183.00
| Facility | | $695.00 | $2,673.72 | $3,183.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $12,767.00 / $23,031.00
| Facility | | $6,164.00 | $12,767.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,320.00 / $10,309.00 / $15,888.00
| Facility | | $3,320.00 | $10,309.00 | $15,888.00 |