- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.18 / $454.18 / $4,828.00
| Facility | | $454.18 | $454.18 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,928.04 / $3,391.03 / $6,657.89
| Facility | | $1,928.04 | $3,391.03 | $6,657.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,870.11 / $5,871.81 / $10,295.70
| Facility | 50 | $3,870.11 | $5,871.81 | $10,295.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.35 / $1,496.63 / $3,600.34
| Facility | | $1,055.35 | $1,496.63 | $3,600.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $857.93 / $1,368.28 / $2,834.91
| Facility | | $857.93 | $1,368.28 | $2,834.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.88 / $872.81 / $7,729.00
| Facility | | $656.88 | $872.81 | $7,729.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |