- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.13 / $369.13 / $8,062.65
| Facility | | $369.13 | $369.13 | $8,062.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,693.57 / $5,904.89 / $13,308.42
| Facility | | $1,693.57 | $5,904.89 | $13,308.42 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,539.04 / $12,955.59 / $22,716.48
| Facility | 50 | $8,539.04 | $12,955.59 | $22,716.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.95 / $1,219.52 / $2,933.72
| Facility | | $859.95 | $1,219.52 | $2,933.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.08 / $1,114.93 / $2,310.01
| Facility | | $699.08 | $1,114.93 | $2,310.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.57 / $712.10 / $7,770.00
| Facility | | $524.57 | $712.10 | $7,770.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,313.52 / $7,313.52 / $7,313.52
| Facility | 50 | $7,313.52 | $7,313.52 | $7,313.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,740.00 / $4,289.00 / $8,193.00
| Facility | | $2,740.00 | $4,289.00 | $8,193.00 |