- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $3,019.95 / $8,709.64
| Facility | | $281.84 | $3,019.95 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,230.27 / $3,388.44 / $7,762.47
| Facility | 50 | $1,230.27 | $3,388.44 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $4,168.69 / $10,000.00
| Facility | | $1,621.81 | $4,168.69 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $467.74 / $1,288.25
| Facility | | $239.88 | $467.74 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,041.74 / $4,897.79
| Facility | | $676.08 | $2,041.74 | $4,897.79 |