- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $7,963.00
| Facility | | $1,671.00 | $4,474.00 | $7,963.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,097.00 / $5,377.50 / $8,112.00
| Facility | 50 | $3,097.00 | $5,377.50 | $8,112.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,531.19 / $4,140.09
| Facility | | $672.35 | $2,531.19 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,469.03 / $4,469.03 / $4,469.03
| Facility | | $4,469.03 | $4,469.03 | $4,469.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.01 / $740.44 / $6,117.00
| Facility | | $491.01 | $740.44 | $6,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,878.00 / $4,545.00 / $7,217.00
| Facility | | $2,878.00 | $4,545.00 | $7,217.00 |