- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $985.17 / $5,483.00 / $17,095.30
| Facility | | $985.17 | $5,483.00 | $17,095.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,674.98 / $7,834.46 / $10,614.45
| Facility | | $6,674.98 | $7,834.46 | $10,614.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,218.80 / $5,458.65 / $7,196.88
| Facility | 50 | $4,218.80 | $5,458.65 | $7,196.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $948.70 / $5,479.74 / $14,223.02
| Facility | | $948.70 | $5,479.74 | $14,223.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,635.00 / $10,192.00 / $12,767.00
| Facility | | $4,635.00 | $10,192.00 | $12,767.00 |