- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.42 / $927.41 / $2,168.00
| Facility | | $179.42 | $927.41 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,738.47 / $3,543.66 / $7,238.46
| Facility | | $1,738.47 | $3,543.66 | $7,238.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,644.39 / $7,046.57 / $12,355.53
| Facility | 50 | $4,644.39 | $7,046.57 | $12,355.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,274.11 / $3,224.97 / $7,758.11
| Facility | | $2,274.11 | $3,224.97 | $7,758.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,848.69 / $2,948.40 / $6,108.75
| Facility | | $1,848.69 | $2,948.40 | $6,108.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.80 / $1,466.68 / $2,940.00
| Facility | | $286.80 | $1,466.68 | $2,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,755.00 / $2,872.00 / $4,241.00
| Facility | | $1,755.00 | $2,872.00 | $4,241.00 |