- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.78 / $3,392.50 / $8,016.63
| Facility | | $849.78 | $3,392.50 | $8,016.63 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,618.51 / $5,618.51 / $5,618.51
| Facility | 50 | $5,618.51 | $5,618.51 | $5,618.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,085.00 / $11,898.00 / $22,154.73
| Facility | | $6,085.00 | $11,898.00 | $22,154.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $919.21 / $919.21 / $1,271.38
| Facility | | $919.21 | $919.21 | $1,271.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.00 / $3,325.00 / $8,198.00
| Facility | | $1,403.00 | $3,325.00 | $8,198.00 |