- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $638.66 / $8,002.00 / $8,442.00
| Facility | | $638.66 | $8,002.00 | $8,442.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,917.48 / $3,917.48 / $3,917.48
| Facility | 50 | $3,917.48 | $3,917.48 | $3,917.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.47 / $836.33 / $1,514.70
| Facility | | $593.47 | $836.33 | $1,514.70 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,101.00 / $1,254.50 / $2,255.35
| Facility | 50 | $1,101.00 | $1,254.50 | $2,255.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,353.00 / $6,885.00 / $9,616.00
| Facility | | $2,353.00 | $6,885.00 | $9,616.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,353.46 / $9,133.70 / $26,542.00
| Facility | | $3,353.46 | $9,133.70 | $26,542.00 |