- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $4,073.80 / $10,715.19
| Facility | | $707.95 | $4,073.80 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,445.44 / $3,715.35 / $7,244.36
| Facility | 50 | $1,445.44 | $3,715.35 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,079.46 / $14,791.08
| Facility | | $2,818.38 | $7,079.46 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,318.26 / $10,000.00
| Facility | | $575.44 | $1,318.26 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $4,365.16 / $10,232.93
| Facility | | $1,584.89 | $4,365.16 | $10,232.93 |