- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.69 / $1,397.00 / $4,478.00
| Facility | | $287.69 | $1,397.00 | $4,478.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,228.43 / $1,228.43 / $1,228.43
| Facility | 50 | $1,228.43 | $1,228.43 | $1,228.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,292.46 / $6,292.46 / $7,550.95
| Facility | | $6,292.46 | $6,292.46 | $7,550.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,953.80 / $2,953.80 / $2,953.80
| Facility | | $2,953.80 | $2,953.80 | $2,953.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.00 / $2,311.00 / $5,626.00
| Facility | | $1,240.00 | $2,311.00 | $5,626.00 |