- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,153.71 / $1,153.71 / $7,761.00
| Facility | | $1,153.71 | $1,153.71 | $7,761.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,194.64 / $1,194.64 / $1,194.64
| Facility | 50 | $1,194.64 | $1,194.64 | $1,194.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,895.78 / $1,895.78 / $1,901.11
| Facility | | $1,895.78 | $1,895.78 | $1,901.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.67 / $940.23 / $1,163.41
| Facility | | $458.67 | $940.23 | $1,163.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,834.98 / $7,849.65 / $9,927.16
| Facility | | $5,834.98 | $7,849.65 | $9,927.16 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,236.46 / $11,774.48 / $15,293.70
| Facility | 50 | $8,236.46 | $11,774.48 | $15,293.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $9,360.00 / $17,870.00
| Facility | | $1,500.00 | $9,360.00 | $17,870.00 |