- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,521.00 / $7,960.15
| Facility | | $1,965.00 | $4,521.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,230.00 / $10,230.00 / $10,230.00
| Facility | 50 | $10,230.00 | $10,230.00 | $10,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.35 / $3,532.98 / $5,814.97
| Facility | | $944.35 | $3,532.98 | $5,814.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,374.52 / $5,374.52 / $5,374.52
| Facility | | $5,374.52 | $5,374.52 | $5,374.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,132.09 / $1,632.38 / $7,207.00
| Facility | | $1,132.09 | $1,632.38 | $7,207.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,094.00 / $6,455.00 / $9,010.00
| Facility | | $4,094.00 | $6,455.00 | $9,010.00 |