- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.52 / $1,342.00 / $3,109.00
| Facility | | $679.52 | $1,342.00 | $3,109.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $438.50 / $3,682.65 / $4,121.47
| Facility | 50 | $438.50 | $3,682.65 | $4,121.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,150.23 / $2,150.23 / $2,580.29
| Facility | | $2,150.23 | $2,150.23 | $2,580.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.30 / $2,368.30 / $2,368.30
| Facility | | $2,368.30 | $2,368.30 | $2,368.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $950.00 / $1,511.00 / $4,064.00
| Facility | | $950.00 | $1,511.00 | $4,064.00 |