- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.00 / $4,528.00 / $8,239.00
| Facility | | $2,073.00 | $4,528.00 | $8,239.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,820.00 / $6,087.00 / $9,025.00
| Facility | 50 | $3,820.00 | $6,087.00 | $9,025.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,377.49 / $5,113.62
| Facility | | $830.45 | $3,377.49 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,645.45 / $4,645.45 / $4,645.45
| Facility | | $4,645.45 | $4,645.45 | $4,645.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.79 / $557.30 / $7,168.00
| Facility | | $375.79 | $557.30 | $7,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,613.00 / $6,477.00 / $9,010.00
| Facility | | $4,613.00 | $6,477.00 | $9,010.00 |