- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,761.34 / $4,933.00 / $6,906.00
| Facility | | $1,761.34 | $4,933.00 | $6,906.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,382.16 / $12,185.61 / $16,509.56
| Facility | | $10,382.16 | $12,185.61 | $16,509.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,979.14 / $9,312.03 / $11,193.92
| Facility | 50 | $5,979.14 | $9,312.03 | $11,193.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.19 / $4,933.00 / $8,060.00
| Facility | | $1,070.19 | $4,933.00 | $8,060.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,356.00 / $11,464.00 / $15,011.00
| Facility | | $5,356.00 | $11,464.00 | $15,011.00 |