- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.85 / $4,933.00 / $6,907.00
| Facility | | $0.85 | $4,933.00 | $6,907.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,384.90 / $2,779.68 / $3,766.03
| Facility | | $2,384.90 | $2,779.68 | $3,766.03 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,284.89 / $1,883.01 / $2,452.10
| Facility | 50 | $1,284.89 | $1,883.01 | $2,452.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.59 / $600.10 / $6,906.00
| Facility | | $466.59 | $600.10 | $6,906.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $5,202.00 / $7,355.00
| Facility | | $2,248.00 | $5,202.00 | $7,355.00 |