- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $2,884.03 / $7,762.47
| Facility | | $331.13 | $2,884.03 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,318.26 / $3,630.78 / $8,128.31
| Facility | 50 | $1,318.26 | $3,630.78 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $4,168.69 / $10,000.00
| Facility | | $1,548.82 | $4,168.69 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $549.54 / $1,348.96
| Facility | | $263.03 | $549.54 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,884.03 / $6,309.57
| Facility | | $1,000.00 | $2,884.03 | $6,309.57 |