- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,585.11 / $2,663.12 / $4,410.00
| Facility | | $1,585.11 | $2,663.12 | $4,410.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,566.00 / $4,801.02 / $4,801.02
| Facility | 50 | $4,566.00 | $4,801.02 | $4,801.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.49 / $4,402.00 / $7,608.00
| Facility | | $816.49 | $4,402.00 | $7,608.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.52 / $494.68 / $972.23
| Facility | | $380.52 | $494.68 | $972.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $493.00 / $6,679.00
| Facility | | $214.32 | $493.00 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,287.00 / $9,401.00
| Facility | | $55.00 | $4,287.00 | $9,401.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |