- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.33 / $622.35 / $8,230.50
| Facility | | $616.33 | $622.35 | $8,230.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $25,742.52 / $25,742.52 / $25,742.52
| Facility | 50 | $25,742.52 | $25,742.52 | $25,742.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,851.90 / $3,851.90 / $3,851.90
| Facility | | $3,851.90 | $3,851.90 | $3,851.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,132.00 / $16,201.22 / $43,896.61
| Facility | | $6,132.00 | $16,201.22 | $43,896.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $2,200.00 / $2,200.00
| Facility | | $2,200.00 | $2,200.00 | $2,200.00 |