- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.88 / $4,933.00 / $13,805.83
| Facility | | $525.88 | $4,933.00 | $13,805.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,782.07 / $5,582.12 / $7,604.38
| Facility | | $4,782.07 | $5,582.12 | $7,604.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,225.49 / $3,802.19 / $5,155.97
| Facility | 50 | $3,225.49 | $3,802.19 | $5,155.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.40 / $4,933.00 / $13,805.83
| Facility | | $398.40 | $4,933.00 | $13,805.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,524.00 / $5,819.00 / $8,339.00
| Facility | | $2,524.00 | $5,819.00 | $8,339.00 |