- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.00 / $6,229.65 / $13,982.00
| Facility | | $630.00 | $6,229.65 | $13,982.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,730.00 / $3,613.38 / $11,554.13
| Facility | 50 | $1,730.00 | $3,613.38 | $11,554.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,417.98 / $12,484.00 / $54,020.00
| Facility | | $2,417.98 | $12,484.00 | $54,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.00 / $12,759.00 / $23,031.00
| Facility | | $5,979.00 | $12,759.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |