- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.50 / $1,235.00 / $2,080.00
| Facility | | $674.50 | $1,235.00 | $2,080.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $617.50 / $2,070.41 / $6,255.43
| Facility | 50 | $617.50 | $2,070.41 | $6,255.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,881.89 / $4,699.34 / $6,322.12
| Facility | | $3,881.89 | $4,699.34 | $6,322.12 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,822.84 / $7,049.02 / $9,483.19
| Facility | 50 | $5,822.84 | $7,049.02 | $9,483.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $834.00 / $2,891.00 / $4,402.00
| Facility | | $834.00 | $2,891.00 | $4,402.00 |