- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.65 / $6,827.06 / $16,042.00
| Facility | | $490.65 | $6,827.06 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,376.27 / $3,919.78 / $7,839.55
| Facility | 50 | $2,376.27 | $3,919.78 | $7,839.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,521.00 / $15,205.00 / $25,750.00
| Facility | | $1,521.00 | $15,205.00 | $25,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.39 / $673.95 / $1,010.93
| Facility | | $477.39 | $673.95 | $1,010.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,251.04 / $3,251.04 / $3,251.04
| Facility | | $3,251.04 | $3,251.04 | $3,251.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |