- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.17 / $3,477.00 / $8,500.00
| Facility | | $338.17 | $3,477.00 | $8,500.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,228.43 / $2,243.94 / $3,204.28
| Facility | 50 | $1,228.43 | $2,243.94 | $3,204.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,321.00 / $7,046.00 / $16,083.00
| Facility | | $3,321.00 | $7,046.00 | $16,083.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,555.20 / $3,009.04 / $3,366.59
| Facility | | $2,555.20 | $3,009.04 | $3,366.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $5,735.00 / $9,622.00
| Facility | | $2,637.00 | $5,735.00 | $9,622.00 |