- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,570.88 / $11,220.18
| Facility | | $1,000.00 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $10,000.00
| Facility | 50 | $1,202.26 | $1,202.26 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $11,220.18 / $22,908.68
| Facility | | $4,073.80 | $11,220.18 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $2,041.74 / $5,754.40
| Facility | | $549.54 | $2,041.74 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $10,232.93
| Facility | | $851.14 | $3,162.28 | $10,232.93 |