- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.87 / $4,350.00 / $9,859.00
| Facility | | $748.87 | $4,350.00 | $9,859.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,367.00 / $7,570.00 / $8,097.53
| Facility | 50 | $6,367.00 | $7,570.00 | $8,097.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,719.00 / $7,166.00 / $12,274.00
| Facility | | $3,719.00 | $7,166.00 | $12,274.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,653.10 / $2,659.03 / $3,438.00
| Facility | | $2,653.10 | $2,659.03 | $3,438.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $3,951.00 / $7,934.00
| Facility | | $1,981.00 | $3,951.00 | $7,934.00 |