- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,319.00 / $10,485.00 / $20,780.12
| Facility | | $2,319.00 | $10,485.00 | $20,780.12 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,772.25 / $10,345.00 / $19,257.05
| Facility | 50 | $4,772.25 | $10,345.00 | $19,257.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,499.48 / $12,484.00 / $54,020.00
| Facility | | $3,499.48 | $12,484.00 | $54,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,078.00 / $12,767.00 / $23,031.00
| Facility | | $6,078.00 | $12,767.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,462.00 / $12,291.00 / $20,609.00
| Facility | | $4,462.00 | $12,291.00 | $20,609.00 |