- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.54 / $1,782.00 / $9,034.00
| Facility | | $538.54 | $1,782.00 | $9,034.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,454.96 / $2,454.96 / $7,726.40
| Facility | 50 | $2,454.96 | $2,454.96 | $7,726.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,782.27 / $4,782.27 / $5,738.72
| Facility | | $4,782.27 | $4,782.27 | $5,738.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,653.03 / $3,653.03 / $3,653.03
| Facility | | $3,653.03 | $3,653.03 | $3,653.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,565.00 / $2,828.00 / $6,992.00
| Facility | | $1,565.00 | $2,828.00 | $6,992.00 |