- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.12 / $7,799.00 / $16,467.00
| Facility | | $243.12 | $7,799.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.00 / $5,475.43 / $10,970.79
| Facility | | $1,737.00 | $5,475.43 | $10,970.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $3,086.58 / $3,966.31
| Facility | | $580.00 | $3,086.58 | $3,966.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.45 / $357.01 / $495.76
| Facility | | $217.45 | $357.01 | $495.76 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $434.14 / $562.50 / $828.12
| Facility | 50 | $434.14 | $562.50 | $828.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |