- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,897.00 / $5,701.06 / $7,761.00
| Facility | | $2,897.00 | $5,701.06 | $7,761.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,929.62 / $7,929.62 / $9,773.98
| Facility | 50 | $7,929.62 | $7,929.62 | $9,773.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.48 / $1,031.05 / $1,472.79
| Facility | | $430.48 | $1,031.05 | $1,472.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,884.56 / $5,546.60 / $7,080.21
| Facility | | $3,884.56 | $5,546.60 | $7,080.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,407.41 / $8,319.90 / $11,041.11
| Facility | 50 | $5,407.41 | $8,319.90 | $11,041.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $5,550.00 / $12,233.00
| Facility | | $1,150.00 | $5,550.00 | $12,233.00 |