- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.04 / $5,880.78 / $6,575.00
| Facility | | $365.04 | $5,880.78 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,268.71 / $8,328.96 / $18,388.59
| Facility | | $3,268.71 | $8,328.96 | $18,388.59 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,798.61 / $17,901.08 / $31,387.96
| Facility | 50 | $11,798.61 | $17,901.08 | $31,387.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.81 / $1,311.49 / $3,154.97
| Facility | | $924.81 | $1,311.49 | $3,154.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $751.80 / $1,199.02 / $2,484.23
| Facility | | $751.80 | $1,199.02 | $2,484.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.42 / $768.97 / $10,493.00
| Facility | | $584.42 | $768.97 | $10,493.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |