- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.73 / $3,279.00 / $8,500.00
| Facility | | $575.73 | $3,279.00 | $8,500.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,088.88 / $2,088.88 / $2,300.50
| Facility | 50 | $2,088.88 | $2,088.88 | $2,300.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.00 / $4,247.00 / $8,800.00
| Facility | | $2,088.00 | $4,247.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.65 / $702.62 / $823.00
| Facility | | $691.65 | $702.62 | $823.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.00 / $1,081.00 / $2,699.00
| Facility | | $282.00 | $1,081.00 | $2,699.00 |