- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.75 / $2,796.60 / $11,093.00
| Facility | | $424.75 | $2,796.60 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,083.39 / $10,055.03 / $11,009.14
| Facility | 50 | $5,083.39 | $10,055.03 | $11,009.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $5,948.00 / $9,462.00
| Facility | | $2,754.00 | $5,948.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.18 / $553.14 / $836.69
| Facility | | $413.18 | $553.14 | $836.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $546.36 / $1,375.01
| Facility | | $450.00 | $546.36 | $1,375.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,399.00 / $5,995.00 / $10,413.00
| Facility | | $1,399.00 | $5,995.00 | $10,413.00 |