- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.71 / $343.71 / $4,828.00
| Facility | | $343.71 | $343.71 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,492.30 / $5,677.23 / $12,389.06
| Facility | | $2,492.30 | $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
- $871.74 / $1,236.24 / $2,973.94
| Facility | | $871.74 | $1,236.24 | $2,973.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.66 / $1,130.22 / $2,341.69
| Facility | | $708.66 | $1,130.22 | $2,341.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.73 / $725.43 / $7,770.00
| Facility | | $556.73 | $725.43 | $7,770.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,312.00 / $8,193.00 / $11,410.31
| Facility | | $3,312.00 | $8,193.00 | $11,410.31 |