- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $770.56 / $8,002.00 / $10,034.00
| Facility | | $770.56 | $8,002.00 | $10,034.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,939.08 / $3,939.08 / $3,939.08
| Facility | 50 | $3,939.08 | $3,939.08 | $3,939.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.11 / $660.14 / $1,500.00
| Facility | | $380.11 | $660.14 | $1,500.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $875.37 / $1,515.42 / $2,250.00
| Facility | 50 | $875.37 | $1,515.42 | $2,250.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,293.00 / $12,081.00 / $19,066.00
| Facility | | $5,293.00 | $12,081.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,135.21 / $14,302.50 / $26,542.00
| Facility | | $2,135.21 | $14,302.50 | $26,542.00 |