- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,179.34 / $6,560.00 / $14,100.00
| Facility | | $2,179.34 | $6,560.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,327.00 / $9,327.00 / $9,327.00
| Facility | 50 | $9,327.00 | $9,327.00 | $9,327.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.00 / $15,433.00 / $15,433.00
| Facility | | $1,326.00 | $15,433.00 | $15,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,273.52 / $2,065.54 / $11,642.00
| Facility | | $1,273.52 | $2,065.54 | $11,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,269.00 / $6,407.00 / $12,224.00
| Facility | | $2,269.00 | $6,407.00 | $12,224.00 |