- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.10 / $2,327.00 / $8,150.53
| Facility | | $293.10 | $2,327.00 | $8,150.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,635.84 / $5,403.37 / $11,143.91
| Facility | | $2,635.84 | $5,403.37 | $11,143.91 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,644.39 / $7,046.57 / $12,355.53
| Facility | 50 | $4,644.39 | $7,046.57 | $12,355.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $786.67 / $1,115.59 / $2,683.73
| Facility | | $786.67 | $1,115.59 | $2,683.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.51 / $1,019.93 / $2,113.17
| Facility | | $639.51 | $1,019.93 | $2,113.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.61 / $654.79 / $5,594.71
| Facility | | $441.61 | $654.79 | $5,594.71 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,439.19 / $6,439.19 / $6,439.19
| Facility | 50 | $6,439.19 | $6,439.19 | $6,439.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |