- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.97 / $7,838.38 / $8,644.27
| Facility | | $890.97 | $7,838.38 | $8,644.27 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,958.00 / $3,958.00 / $3,958.00
| Facility | 50 | $3,958.00 | $3,958.00 | $3,958.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,530.68 / $25,263.22 / $42,322.62
| Facility | | $10,530.68 | $25,263.22 | $42,322.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.87 / $524.87 / $524.87
| Facility | | $524.87 | $524.87 | $524.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,602.00 / $9,127.00 / $10,150.00
| Facility | | $6,602.00 | $9,127.00 | $10,150.00 |