- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $888.78 / $4,069.00 / $10,234.00
| Facility | | $888.78 | $4,069.00 | $10,234.00 |
- 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
- $2,523.00 / $4,657.00 / $7,950.00
| Facility | | $2,523.00 | $4,657.00 | $7,950.00 |
- 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 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,799.00 / $5,728.00 / $10,111.00
| Facility | | $2,799.00 | $5,728.00 | $10,111.00 |