- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.30 / $1,854.00 / $16,042.00
| Facility | | $437.30 | $1,854.00 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,059.84 / $4,006.84 / $13,065.92
| Facility | 50 | $3,059.84 | $4,006.84 | $13,065.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,521.00 / $13,414.00 / $25,750.00
| Facility | | $1,521.00 | $13,414.00 | $25,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.94 / $601.32 / $901.98
| Facility | | $425.94 | $601.32 | $901.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,251.04 / $3,251.04 / $3,251.04
| Facility | | $3,251.04 | $3,251.04 | $3,251.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |