- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.76 / $3,413.54 / $11,093.00
| Facility | | $229.76 | $3,413.54 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,802.51 / $3,802.51 / $4,532.45
| Facility | 50 | $3,802.51 | $3,802.51 | $4,532.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,321.00 / $7,890.00 / $21,000.00
| Facility | | $3,321.00 | $7,890.00 | $21,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.02 / $316.39 / $474.60
| Facility | | $232.02 | $316.39 | $474.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,251.04 / $3,251.04 / $3,251.04
| Facility | | $3,251.04 | $3,251.04 | $3,251.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,348.00 / $11,284.00
| Facility | | $3,932.00 | $8,348.00 | $11,284.00 |