- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.05 / $6,673.80 / $16,467.00
| Facility | | $446.05 | $6,673.80 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.00 / $5,626.41 / $10,089.79
| Facility | | $1,737.00 | $5,626.41 | $10,089.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,106.17 / $2,106.17 / $2,706.47
| Facility | | $2,106.17 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.14 / $525.00 / $815.19
| Facility | | $379.14 | $525.00 | $815.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $775.68 / $787.50 / $1,086.45
| Facility | 50 | $775.68 | $787.50 | $1,086.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $10,918.00 / $16,786.68
| Facility | | $1,981.00 | $10,918.00 | $16,786.68 |