- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $4,677.35 / $11,748.98
| Facility | | $831.76 | $4,677.35 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,511.89 / $8,128.31 / $14,125.38
| Facility | 50 | $2,511.89 | $8,128.31 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,762.47 / $16,595.87
| Facility | | $2,951.21 | $7,762.47 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,479.11 / $10,000.00
| Facility | | $616.60 | $1,479.11 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | 22 | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $4,365.16 / $10,964.78
| Facility | | $1,584.89 | $4,365.16 | $10,964.78 |