- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.39 / $2,678.00 / $7,602.00
| Facility | | $837.39 | $2,678.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,480.00 / $5,274.00 / $13,130.23
| Facility | 50 | $2,480.00 | $5,274.00 | $13,130.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,660.00 / $2,859.00 / $3,766.00
| Facility | | $1,660.00 | $2,859.00 | $3,766.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,484.78 / $5,819.45 / $26,542.00
| Facility | | $2,484.78 | $5,819.45 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.00 / $3,626.00 / $6,291.00
| Facility | | $1,794.00 | $3,626.00 | $6,291.00 |