- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.13 / $6,040.68 / $11,986.00
| Facility | | $436.13 | $6,040.68 | $11,986.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,247.30 / $4,590.16 / $5,680.34
| Facility | 50 | $1,247.30 | $4,590.16 | $5,680.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.13 / $604.79 / $1,048.83
| Facility | | $436.13 | $604.79 | $1,048.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $907.19 / $907.19 / $1,645.88
| Facility | 50 | $907.19 | $907.19 | $1,645.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.00 / $9,541.00 / $14,589.00
| Facility | | $3,366.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,452.80 / $5,897.00 / $13,759.35
| Facility | | $2,452.80 | $5,897.00 | $13,759.35 |