- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.73 / $4,112.00 / $4,933.00
| Facility | | $569.73 | $4,112.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,087.36 / $2,436.58 / $3,319.29
| Facility | | $2,087.36 | $2,436.58 | $3,319.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,126.33 / $1,707.00 / $1,921.10
| Facility | 50 | $1,126.33 | $1,707.00 | $1,921.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.74 / $4,112.00 / $4,933.00
| Facility | | $461.74 | $4,112.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,524.00 / $5,819.00 / $8,339.00
| Facility | | $2,524.00 | $5,819.00 | $8,339.00 |