- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $838.76 / $4,521.00 / $9,872.00
| Facility | | $838.76 | $4,521.00 | $9,872.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,915.72 / $4,923.89 / $11,271.00
| Facility | 50 | $1,915.72 | $4,923.89 | $11,271.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,583.00 / $8,007.00 / $16,083.00
| Facility | | $4,583.00 | $8,007.00 | $16,083.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,558.05 / $3,064.29 / $3,482.15
| Facility | | $2,558.05 | $3,064.29 | $3,482.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $5,735.00 / $9,622.00
| Facility | | $2,637.00 | $5,735.00 | $9,622.00 |