- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,511.00 / $6,560.00 / $13,327.60
| Facility | | $1,511.00 | $6,560.00 | $13,327.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $716.07 / $1,552.42 / $5,313.35
| Facility | 50 | $716.07 | $1,552.42 | $5,313.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,909.33 / $5,060.37 / $7,456.55
| Facility | | $1,909.33 | $5,060.37 | $7,456.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.00 / $11,533.00 / $11,533.00
| Facility | | $11,533.00 | $11,533.00 | $11,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.30 / $1,833.00 / $5,897.00
| Facility | | $470.30 | $1,833.00 | $5,897.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,946.00 / $7,504.00
| Facility | | $1,779.00 | $3,946.00 | $7,504.00 |