- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.82 / $3,804.98 / $9,025.50
| Facility | | $682.82 | $3,804.98 | $9,025.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,771.84 / $4,006.84 / $11,149.37
| Facility | 50 | $1,771.84 | $4,006.84 | $11,149.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,826.00 / $7,362.00 / $16,083.00
| Facility | | $2,826.00 | $7,362.00 | $16,083.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,558.05 / $3,251.04 / $3,966.31
| Facility | | $2,558.05 | $3,251.04 | $3,966.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $5,735.00 / $9,622.00
| Facility | | $2,637.00 | $5,735.00 | $9,622.00 |