- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,343.54 / $4,521.00 / $9,907.00
| Facility | | $1,343.54 | $4,521.00 | $9,907.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,230.00 / $10,230.00 / $17,184.32
| Facility | 50 | $10,230.00 | $10,230.00 | $17,184.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,877.00 / $7,264.00 / $12,274.00
| Facility | | $3,877.00 | $7,264.00 | $12,274.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,069.49 / $3,393.92 / $3,909.74
| Facility | | $3,069.49 | $3,393.92 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,578.00 / $12,241.00
| Facility | | $3,206.00 | $6,578.00 | $12,241.00 |