- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.00 / $4,521.00 / $7,960.15
| Facility | | $2,073.00 | $4,521.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $12,358.50 / $12,358.50 / $35,553.37
| Facility | 50 | $12,358.50 | $12,358.50 | $35,553.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,106.86 / $5,113.62
| Facility | | $830.45 | $3,106.86 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,768.35 / $1,768.35 / $1,768.35
| Facility | | $1,768.35 | $1,768.35 | $1,768.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.28 / $473.73 / $3,790.00
| Facility | | $331.28 | $473.73 | $3,790.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |