- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.44 / $1,245.00 / $10,561.00
| Facility | | $647.44 | $1,245.00 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,185.50 / $3,185.50 / $3,231.98
| Facility | | $3,185.50 | $3,185.50 | $3,231.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $6,025.59
| Facility | | $748.70 | $748.70 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.44 / $802.37 / $1,321.61
| Facility | | $647.44 | $802.37 | $1,321.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,171.50 / $1,203.56 / $2,291.94
| Facility | 50 | $1,171.50 | $1,203.56 | $2,291.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,119.85 / $19,913.50 / $33,500.00
| Facility | | $3,119.85 | $19,913.50 | $33,500.00 |