- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.53 / $2,128.00 / $7,045.00
| Facility | | $208.53 | $2,128.00 | $7,045.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,169.91 / $4,527.00 / $4,527.00
| Facility | 50 | $3,169.91 | $4,527.00 | $4,527.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,143.00 / $4,120.00 / $8,800.00
| Facility | | $2,143.00 | $4,120.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,212.55 / $1,216.92 / $1,461.41
| Facility | | $1,212.55 | $1,216.92 | $1,461.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,218.00 / $5,743.33
| Facility | | $1,640.00 | $3,218.00 | $5,743.33 |