- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.02 / $2,789.14 / $9,727.00
| Facility | | $309.02 | $2,789.14 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.00 / $2,664.00 / $8,385.85
| Facility | | $1,040.00 | $2,664.00 | $8,385.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,106.17 / $2,106.17 / $2,706.47
| Facility | | $2,106.17 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.02 / $1,316.43 / $1,981.14
| Facility | | $309.02 | $1,316.43 | $1,981.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $673.59 / $2,245.73 / $2,971.71
| Facility | 50 | $673.59 | $2,245.73 | $2,971.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |