- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.00 / $3,420.00 / $8,229.00
| Facility | | $850.00 | $3,420.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,427.30 / $6,662.64 / $9,773.98
| Facility | 50 | $3,427.30 | $6,662.64 | $9,773.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,385.00 / $4,133.00 / $8,800.00
| Facility | | $2,385.00 | $4,133.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.00 / $814.23 / $1,304.32
| Facility | | $689.00 | $814.23 | $1,304.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,683.00 / $3,833.00 / $7,790.50
| Facility | | $1,683.00 | $3,833.00 | $7,790.50 |