- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,521.00 / $7,963.00
| Facility | | $1,671.00 | $4,521.00 | $7,963.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,322.75 / $8,436.00 / $9,077.50
| Facility | 50 | $2,322.75 | $8,436.00 | $9,077.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,531.19 / $4,140.09
| Facility | | $672.35 | $2,531.19 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,469.03 / $4,469.03 / $4,469.03
| Facility | | $4,469.03 | $4,469.03 | $4,469.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.00 / $784.17 / $6,117.00
| Facility | | $520.00 | $784.17 | $6,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,878.00 / $4,545.00 / $7,217.00
| Facility | | $2,878.00 | $4,545.00 | $7,217.00 |