- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $5,269.19 / $12,154.00
| Facility | | $1,547.00 | $5,269.19 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,521.50 / $2,521.50 / $2,521.50
| Facility | 50 | $2,521.50 | $2,521.50 | $2,521.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.00 / $4,247.00 / $9,663.00
| Facility | | $2,088.00 | $4,247.00 | $9,663.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.00 / $804.27 / $22,240.43
| Facility | | $406.00 | $804.27 | $22,240.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,644.00 / $2,874.00 / $5,813.00
| Facility | | $1,644.00 | $2,874.00 | $5,813.00 |