- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.57 / $4,933.00 / $5,757.00
| Facility | | $498.57 | $4,933.00 | $5,757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,886.06 / $2,213.67 / $2,999.19
| Facility | | $1,886.06 | $2,213.67 | $2,999.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,017.71 / $1,691.66 / $2,033.53
| Facility | 50 | $1,017.71 | $1,691.66 | $2,033.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $386.52 / $4,933.00 / $5,757.00
| Facility | | $386.52 | $4,933.00 | $5,757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,050.00 / $3,640.00 / $6,327.00
| Facility | | $1,050.00 | $3,640.00 | $6,327.00 |