- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.63 / $436.63 / $2,600.00
| Facility | | $436.63 | $436.63 | $2,600.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,600.75 / $3,600.75 / $3,999.58
| Facility | 50 | $3,600.75 | $3,600.75 | $3,999.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.32 / $525.79 / $572.87
| Facility | | $471.32 | $525.79 | $572.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.22 / $506.22 / $506.22
| Facility | | $506.22 | $506.22 | $506.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,187.31 / $6,875.19 / $29,212.37
| Facility | | $3,187.31 | $6,875.19 | $29,212.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,489.51 / $3,853.39 / $32,253.35
| Facility | 50 | $2,489.51 | $3,853.39 | $32,253.35 |