- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.72 / $4,204.20 / $9,034.00
| Facility | | $560.72 | $4,204.20 | $9,034.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,546.26 / $7,398.91 / $8,369.56
| Facility | 50 | $6,546.26 | $7,398.91 | $8,369.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,740.00 / $4,120.00 / $8,800.00
| Facility | | $2,740.00 | $4,120.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,001.48 / $1,063.89 / $1,473.64
| Facility | | $1,001.48 | $1,063.89 | $1,473.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $3,951.00 / $7,934.00
| Facility | | $1,981.00 | $3,951.00 | $7,934.00 |