- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $4,728.00 / $14,100.00
| Facility | | $1,392.00 | $4,728.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,552.42 / $5,612.25 / $10,489.50
| Facility | 50 | $1,552.42 | $5,612.25 | $10,489.50 |
- 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
- $521.38 / $2,495.00 / $7,214.89
| Facility | | $521.38 | $2,495.00 | $7,214.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,100.81 / $2,100.81 / $2,100.81
| Facility | 50 | $2,100.81 | $2,100.81 | $2,100.81 |
- 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 |