- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,821.00 / $12,600.00
| Facility | | $1,000.00 | $3,821.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,545.68 / $5,967.00 / $9,364.54
| Facility | 50 | $4,545.68 | $5,967.00 | $9,364.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,682.77 / $10,633.55 / $16,921.82
| Facility | | $6,682.77 | $10,633.55 | $16,921.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.25 / $1,070.25 / $1,070.25
| Facility | | $1,070.25 | $1,070.25 | $1,070.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.00 / $1,807.00 / $5,882.00
| Facility | | $521.00 | $1,807.00 | $5,882.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $2,875.93 / $5,543.93
| Facility | | $884.00 | $2,875.93 | $5,543.93 |