- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.39 / $5,391.00 / $11,062.03
| Facility | | $748.39 | $5,391.00 | $11,062.03 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,675.00 / $9,108.00 / $9,848.00
| Facility | 50 | $6,675.00 | $9,108.00 | $9,848.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,877.00 / $7,264.00 / $12,926.58
| Facility | | $3,877.00 | $7,264.00 | $12,926.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,185.25 / $3,379.37 / $4,122.88
| Facility | | $3,185.25 | $3,379.37 | $4,122.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $7,228.00 / $12,241.00
| Facility | | $3,206.00 | $7,228.00 | $12,241.00 |