- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $897.30 / $4,858.00 / $10,435.00
| Facility | | $897.30 | $4,858.00 | $10,435.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,543.22 / $7,716.00 / $10,435.00
| Facility | 50 | $1,543.22 | $7,716.00 | $10,435.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.00 / $4,449.00 / $10,043.00
| Facility | | $2,224.00 | $4,449.00 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.00 / $13,106.00 / $17,811.00
| Facility | | $11,533.00 | $13,106.00 | $17,811.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.45 / $1,000.00 / $5,897.00
| Facility | | $444.45 | $1,000.00 | $5,897.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,748.00 / $3,527.00 / $7,042.00
| Facility | | $1,748.00 | $3,527.00 | $7,042.00 |