- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,211.00 / $6,829.00 / $13,982.00
| Facility | | $1,211.00 | $6,829.00 | $13,982.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,961.78 / $9,773.79 / $9,773.79
| Facility | 50 | $3,961.78 | $9,773.79 | $9,773.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,513.44 / $12,484.00 / $54,020.00
| Facility | | $2,513.44 | $12,484.00 | $54,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.00 / $12,759.00 / $23,031.00
| Facility | | $5,979.00 | $12,759.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,681.00 / $5,811.00 / $10,057.00
| Facility | | $1,681.00 | $5,811.00 | $10,057.00 |