- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $5,167.63 / $12,669.00
| Facility | | $761.00 | $5,167.63 | $12,669.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,306.25 / $6,399.99 / $11,762.59
| Facility | 50 | $1,306.25 | $6,399.99 | $11,762.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $2,417.98 / $2,878.56
| Facility | | $323.00 | $2,417.98 | $2,878.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,855.00 / $12,742.00 / $23,031.00
| Facility | | $5,855.00 | $12,742.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |