- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.58 / $1,153.73 / $2,525.00
| Facility | | $238.58 | $1,153.73 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $486.79 / $5,483.97 / $12,389.06
| Facility | | $486.79 | $5,483.97 | $12,389.06 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,949.16 / $12,060.61 / $21,147.21
| Facility | 50 | $7,949.16 | $12,060.61 | $21,147.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,830.85 / $4,014.50 / $9,657.41
| Facility | | $2,830.85 | $4,014.50 | $9,657.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,301.28 / $3,670.21 / $7,604.26
| Facility | | $2,301.28 | $3,670.21 | $7,604.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.19 / $1,824.62 / $6,740.00
| Facility | | $382.19 | $1,824.62 | $6,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |