- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.45 / $6,588.15 / $11,243.00
| Facility | | $1,436.45 | $6,588.15 | $11,243.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,830.50 / $8,830.50 / $8,830.50
| Facility | 50 | $8,830.50 | $8,830.50 | $8,830.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,576.00 / $14,996.00
| Facility | | $1,760.00 | $3,576.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.60 / $682.32 / $1,066.13
| Facility | | $568.60 | $682.32 | $1,066.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,774.86 / $3,774.86 / $3,774.86
| Facility | | $3,774.86 | $3,774.86 | $3,774.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,647.00 / $4,410.00 / $7,373.90
| Facility | | $2,647.00 | $4,410.00 | $7,373.90 |