- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.00 / $2,663.12 / $4,410.00
| Facility | | $1,015.00 | $2,663.12 | $4,410.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $475.18 / $1,669.03 / $3,814.31
| Facility | 50 | $475.18 | $1,669.03 | $3,814.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $486.89 / $5,268.00 / $15,940.91
| Facility | | $486.89 | $5,268.00 | $15,940.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.63 / $422.06 / $6,679.00
| Facility | | $201.63 | $422.06 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,941.55 / $2,941.55 / $2,941.55
| Facility | | $2,941.55 | $2,941.55 | $2,941.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $6,104.00 / $26,542.00
| Facility | | $1,485.00 | $6,104.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |