- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.02 / $3,011.47 / $6,915.00
| Facility | | $457.02 | $3,011.47 | $6,915.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,700.13 / $6,700.13 / $11,004.96
| Facility | 50 | $6,700.13 | $6,700.13 | $11,004.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.00 / $3,931.00 / $8,240.00
| Facility | | $1,905.00 | $3,931.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,090.96 / $2,090.96 / $2,218.40
| Facility | | $2,090.96 | $2,090.96 | $2,218.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $3,951.00 / $7,934.00
| Facility | | $1,981.00 | $3,951.00 | $7,934.00 |