- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $648.46 / $5,560.00 / $11,271.00
| Facility | | $648.46 | $5,560.00 | $11,271.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,556.50 / $4,858.00 / $11,271.00
| Facility | 50 | $3,556.50 | $4,858.00 | $11,271.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.00 / $4,449.00 / $10,043.00
| Facility | | $2,224.00 | $4,449.00 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.00 / $13,106.00 / $17,811.00
| Facility | | $11,533.00 | $13,106.00 | $17,811.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.82 / $1,020.84 / $5,897.00
| Facility | | $498.82 | $1,020.84 | $5,897.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,748.00 / $3,527.00 / $7,042.00
| Facility | | $1,748.00 | $3,527.00 | $7,042.00 |