- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.00 / $3,239.00 / $7,467.00
| Facility | | $1,070.00 | $3,239.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,314.00 / $2,282.25 / $6,141.00
| Facility | 50 | $1,314.00 | $2,282.25 | $6,141.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,515.38 / $4,140.09
| Facility | | $672.35 | $2,515.38 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,966.61 / $2,966.61 / $2,966.61
| Facility | | $2,966.61 | $2,966.61 | $2,966.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.08 / $266.43 / $3,801.00
| Facility | | $189.08 | $266.43 | $3,801.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,603.04 / $2,603.04 / $2,603.04
| Facility | 50 | $2,603.04 | $2,603.04 | $2,603.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,381.00 / $3,533.00 / $5,838.00
| Facility | | $2,381.00 | $3,533.00 | $5,838.00 |