- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.60 / $1,831.00 / $8,062.57
| Facility | | $424.60 | $1,831.00 | $8,062.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,454.96 / $2,454.96 / $2,454.96
| Facility | 50 | $2,454.96 | $2,454.96 | $2,454.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,569.15 / $2,569.15 / $2,569.15
| Facility | | $2,569.15 | $2,569.15 | $2,569.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,608.65 / $2,608.65 / $5,414.61
| Facility | | $2,608.65 | $2,608.65 | $5,414.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $985.00 / $3,428.00 / $9,302.00
| Facility | | $985.00 | $3,428.00 | $9,302.00 |