- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $621.00 / $5,654.12 / $11,550.00
| Facility | | $621.00 | $5,654.12 | $11,550.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,655.54 / $9,570.53 / $19,644.81
| Facility | 50 | $1,655.54 | $9,570.53 | $19,644.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.00 / $1,649.96 / $1,964.23
| Facility | | $494.00 | $1,649.96 | $1,964.23 |
- 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
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |