- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,599.82 / $5,547.65 / $11,627.00
| Facility | | $1,599.82 | $5,547.65 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $17,184.32 / $17,184.32 / $17,184.32
| Facility | 50 | $17,184.32 | $17,184.32 | $17,184.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,084.00 / $4,426.00 / $19,117.00
| Facility | | $2,084.00 | $4,426.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,027.79 / $1,233.34 / $1,526.54
| Facility | | $1,027.79 | $1,233.34 | $1,526.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,578.00 / $10,075.00
| Facility | | $3,206.00 | $6,578.00 | $10,075.00 |