- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $4,918.07 / $13,200.00
| Facility | | $1,346.00 | $4,918.07 | $13,200.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,302.00 / $4,302.00 / $9,580.50
| Facility | 50 | $4,302.00 | $4,302.00 | $9,580.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,550.80 / $8,653.12 / $13,616.87
| Facility | | $5,550.80 | $8,653.12 | $13,616.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.23 / $965.00 / $10,198.00
| Facility | | $445.23 | $965.00 | $10,198.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,280.00 / $5,524.00 / $9,232.95
| Facility | | $1,280.00 | $5,524.00 | $9,232.95 |