- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $4,470.00 / $8,877.44
| Facility | | $1,258.00 | $4,470.00 | $8,877.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,530.50 / $6,662.64 / $8,704.00
| Facility | 50 | $2,530.50 | $6,662.64 | $8,704.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.00 / $4,279.00 / $9,663.00
| Facility | | $2,088.00 | $4,279.00 | $9,663.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.00 / $5,493.00 / $7,292.00
| Facility | | $591.00 | $5,493.00 | $7,292.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.25 / $2,237.00 / $26,542.00
| Facility | | $503.25 | $2,237.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,644.00 / $2,874.00 / $5,813.00
| Facility | | $1,644.00 | $2,874.00 | $5,813.00 |