- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.95 / $4,407.56 / $10,596.77
| Facility | | $410.95 | $4,407.56 | $10,596.77 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,701.94 / $6,701.94 / $6,701.94
| Facility | 50 | $6,701.94 | $6,701.94 | $6,701.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,614.00 / $9,200.00 / $18,942.00
| Facility | | $1,614.00 | $9,200.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.68 / $599.54 / $899.31
| Facility | | $424.68 | $599.54 | $899.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,061.25 / $2,061.25 / $2,061.25
| Facility | | $2,061.25 | $2,061.25 | $2,061.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |