- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $4,634.00 / $14,100.00
| Facility | | $1,456.00 | $4,634.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,249.23 / $7,071.00 / $8,572.50
| Facility | 50 | $1,249.23 | $7,071.00 | $8,572.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,175.22 / $6,586.45 / $10,479.96
| Facility | | $4,175.22 | $6,586.45 | $10,479.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $492.47 / $2,452.80 / $7,214.89
| Facility | | $492.47 | $2,452.80 | $7,214.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,091.00 / $4,054.00 / $7,077.94
| Facility | | $1,091.00 | $4,054.00 | $7,077.94 |