- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.95 / $3,000.30 / $7,968.00
| Facility | | $526.95 | $3,000.30 | $7,968.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $877.87 / $1,493.17 / $5,212.03
| Facility | 50 | $877.87 | $1,493.17 | $5,212.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.95 / $708.00 / $1,071.43
| Facility | | $526.95 | $708.00 | $1,071.43 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $744.00 / $1,062.00 / $1,683.14
| Facility | 50 | $744.00 | $1,062.00 | $1,683.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,526.00 / $7,659.00 / $10,502.00
| Facility | | $2,526.00 | $7,659.00 | $10,502.00 |
- 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 |