- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,418.80 / $9,335.53
| Facility | | $900.00 | $3,418.80 | $9,335.53 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,542.15 / $3,136.25 / $9,547.87
| Facility | 50 | $1,542.15 | $3,136.25 | $9,547.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,852.29 / $2,852.29 / $2,852.29
| Facility | | $2,852.29 | $2,852.29 | $2,852.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,959.06 / $2,959.06 / $6,572.11
| Facility | | $2,959.06 | $2,959.06 | $6,572.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $4,797.00 / $10,455.00
| Facility | | $1,185.00 | $4,797.00 | $10,455.00 |