- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.45 / $1,848.32 / $4,933.00
| Facility | | $409.45 | $1,848.32 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,200.50 / $4,903.25 / $6,679.57
| Facility | | $4,200.50 | $4,903.25 | $6,679.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,266.58 / $3,092.75 / $4,528.93
| Facility | 50 | $2,266.58 | $3,092.75 | $4,528.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.25 / $2,106.33 / $4,933.00
| Facility | | $325.25 | $2,106.33 | $4,933.00 |
- 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 |