- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.80 / $6,404.00 / $12,154.00
| Facility | | $1,148.80 | $6,404.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,454.91 / $5,353.50 / $7,016.00
| Facility | 50 | $3,454.91 | $5,353.50 | $7,016.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,885.76 / $4,873.41 / $7,456.55
| Facility | | $1,885.76 | $4,873.41 | $7,456.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.00 / $11,533.00 / $11,533.00
| Facility | | $11,533.00 | $11,533.00 | $11,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.45 / $1,833.00 / $5,897.00
| Facility | | $444.45 | $1,833.00 | $5,897.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,946.00 / $7,914.02
| Facility | | $1,779.00 | $3,946.00 | $7,914.02 |