- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,009.15 / $2,933.00 / $5,506.00
| Facility | | $1,009.15 | $2,933.00 | $5,506.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,012.20 / $6,864.00 / $7,139.00
| Facility | 50 | $4,012.20 | $6,864.00 | $7,139.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.60 / $1,640.88 / $2,700.74
| Facility | | $438.60 | $1,640.88 | $2,700.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,768.35 / $1,768.35 / $1,768.35
| Facility | | $1,768.35 | $1,768.35 | $1,768.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.58 / $541.37 / $2,017.00
| Facility | | $84.58 | $541.37 | $2,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,578.00 / $2,567.00 / $5,029.00
| Facility | | $1,578.00 | $2,567.00 | $5,029.00 |