- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $4,470.00 / $12,600.00
| Facility | | $1,456.00 | $4,470.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,109.02 / $1,509.40 / $1,509.40
| Facility | 50 | $1,109.02 | $1,509.40 | $1,509.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.10 / $5,060.37 / $8,635.50
| Facility | | $1,461.10 | $5,060.37 | $8,635.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.00 / $11,533.00 / $11,533.00
| Facility | | $11,533.00 | $11,533.00 | $11,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.06 / $411.42 / $12,887.09
| Facility | | $201.06 | $411.42 | $12,887.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,647.00 / $6,988.00
| Facility | | $1,779.00 | $3,647.00 | $6,988.00 |