- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.00 / $1,502.00 / $2,731.57
| Facility | | $750.00 | $1,502.00 | $2,731.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,301.92 / $4,301.92 / $4,301.92
| Facility | 50 | $4,301.92 | $4,301.92 | $4,301.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,644.37 / $3,644.37 / $3,644.37
| Facility | | $3,644.37 | $3,644.37 | $3,644.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,244.37 / $4,015.30 / $10,477.79
| Facility | | $3,244.37 | $4,015.30 | $10,477.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $5,261.00 / $11,325.00
| Facility | | $1,185.00 | $5,261.00 | $11,325.00 |