- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.09 / $970.09 / $7,093.00
| Facility | | $970.09 | $970.09 | $7,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.43 / $2,110.42 / $7,333.11
| Facility | | $816.43 | $2,110.42 | $7,333.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,432.44 / $2,173.33 / $3,810.74
| Facility | 50 | $1,432.44 | $2,173.33 | $3,810.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,149.46 / $3,048.20 / $7,332.85
| Facility | | $2,149.46 | $3,048.20 | $7,332.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,747.35 / $2,786.78 / $5,773.90
| Facility | | $1,747.35 | $2,786.78 | $5,773.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,442.12 / $1,777.30 / $10,831.00
| Facility | | $1,442.12 | $1,777.30 | $10,831.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |