- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.12 / $2,868.00 / $8,436.50
| Facility | | $293.12 | $2,868.00 | $8,436.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $985.40 / $2,509.30 / $6,849.00
| Facility | 50 | $985.40 | $2,509.30 | $6,849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $4,945.58 / $10,470.00
| Facility | | $3,283.00 | $4,945.58 | $10,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,696.18 / $2,223.77 / $2,960.20
| Facility | | $1,696.18 | $2,223.77 | $2,960.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $3,951.00 / $7,934.00
| Facility | | $1,981.00 | $3,951.00 | $7,934.00 |