- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.50 / $2,496.00 / $6,125.72
| Facility | | $301.50 | $2,496.00 | $6,125.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,375.50 / $2,789.52 / $3,506.80
| Facility | 50 | $2,375.50 | $2,789.52 | $3,506.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,449.90 / $3,693.00 / $5,962.00
| Facility | | $1,449.90 | $3,693.00 | $5,962.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.47 / $477.58 / $814.93
| Facility | | $370.47 | $477.58 | $814.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $1,917.00 / $4,132.00
| Facility | | $1,020.00 | $1,917.00 | $4,132.00 |