- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $7,079.46
| Facility | | $457.09 | $457.09 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,398.83 / $4,073.80 / $9,332.54
| Facility | 50 | $2,398.83 | $4,073.80 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $13,182.57 / $31,622.78
| Facility | | $2,691.53 | $13,182.57 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $16,218.10 / $29,512.09 / $74,131.02
| Facility | 50 | $16,218.10 | $29,512.09 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,584.89 / $3,801.89
| Facility | | $1,122.02 | $1,584.89 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,513.56 / $2,951.21
| Facility | | $1,230.27 | $1,513.56 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,096.48 / $10,000.00
| Facility | | $489.78 | $1,096.48 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.54 / $3,548.13 / $5,623.41
| Facility | 50 | $0.54 | $3,548.13 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $6,760.83 / $17,782.79
| Facility | | $1,584.89 | $6,760.83 | $17,782.79 |