- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,073.31 / $5,706.00 / $10,268.00
| Facility | | $1,073.31 | $5,706.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,232.02 / $3,276.30 / $9,831.00
| Facility | 50 | $3,232.02 | $3,276.30 | $9,831.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.00 / $3,025.00 / $8,800.00
| Facility | | $1,191.00 | $3,025.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.26 / $373.51 / $496.07
| Facility | | $311.26 | $373.51 | $496.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,529.67 / $4,529.67 / $4,529.67
| Facility | | $4,529.67 | $4,529.67 | $4,529.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $5,998.00 / $7,847.00
| Facility | | $2,840.00 | $5,998.00 | $7,847.00 |