- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $6,154.00 / $14,333.00
| Facility | | $761.00 | $6,154.00 | $14,333.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,819.57 / $3,718.06 / $15,237.71
| Facility | 50 | $1,819.57 | $3,718.06 | $15,237.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,417.98 / $12,484.00 / $54,020.00
| Facility | | $2,417.98 | $12,484.00 | $54,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,855.00 / $12,742.00 / $23,031.00
| Facility | | $5,855.00 | $12,742.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |