- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,087.19 / $4,634.00 / $14,100.00
| Facility | | $1,087.19 | $4,634.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,679.90 / $7,071.00 / $7,315.61
| Facility | 50 | $3,679.90 | $7,071.00 | $7,315.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,091.22 / $11,208.10 / $17,846.03
| Facility | | $7,091.22 | $11,208.10 | $17,846.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $805.06 / $1,303.22 / $10,198.00
| Facility | | $805.06 | $1,303.22 | $10,198.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,280.00 / $5,524.00 / $9,232.95
| Facility | | $1,280.00 | $5,524.00 | $9,232.95 |