- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $8,317.64 / $20,417.38
| Facility | | $457.09 | $8,317.64 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,311.31 / $7,943.28 / $18,197.01
| Facility | 50 | $3,311.31 | $7,943.28 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,981.07 / $9,549.93
| Facility | | $1,348.96 | $3,981.07 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $3,981.07
| Facility | | $575.44 | $575.44 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $691.83 / $1,000.00
| Facility | | $407.38 | $691.83 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |