- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,279.36 / $4,005.00 / $7,960.15
| Facility | | $1,279.36 | $4,005.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,300.50 / $2,300.50 / $2,300.50
| Facility | 50 | $2,300.50 | $2,300.50 | $2,300.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.65 / $1,615.66 / $2,559.42
| Facility | | $415.65 | $1,615.66 | $2,559.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.00 / $775.00 / $858.00
| Facility | | $775.00 | $775.00 | $858.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.75 / $668.53 / $2,041.00
| Facility | | $210.75 | $668.53 | $2,041.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $1,535.00 / $2,175.00
| Facility | | $617.00 | $1,535.00 | $2,175.00 |