- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.22 / $265.22 / $4,828.00
| Facility | | $265.22 | $265.22 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,686.30 / $5,677.23 / $12,389.06
| Facility | | $1,686.30 | $5,677.23 | $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
- $672.13 / $953.16 / $2,292.94
| Facility | | $672.13 | $953.16 | $2,292.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.39 / $871.42 / $1,805.48
| Facility | | $546.39 | $871.42 | $1,805.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.67 / $558.63 / $7,770.00
| Facility | | $426.67 | $558.63 | $7,770.00 |
- 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 |