- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,555.86 / $4,634.88 / $10,043.00
| Facility | | $1,555.86 | $4,634.88 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,113.00 / $3,901.50 / $3,901.50
| Facility | 50 | $3,113.00 | $3,901.50 | $3,901.50 |
- 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
- $730.00 / $5,493.00 / $7,292.00
| Facility | | $730.00 | $5,493.00 | $7,292.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.19 / $2,808.00 / $26,542.00
| Facility | | $735.19 | $2,808.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,472.07 / $3,347.00 / $6,854.00
| Facility | | $1,472.07 | $3,347.00 | $6,854.00 |