- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $867.83 / $867.83 / $6,575.00
| Facility | | $867.83 | $867.83 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,462.48 / $6,726.72 / $14,294.22
| Facility | | $3,462.48 | $6,726.72 | $14,294.22 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,816.17 / $13,376.05 / $23,453.73
| Facility | 50 | $8,816.17 | $13,376.05 | $23,453.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,011.97 / $2,854.70 / $6,867.37
| Facility | | $2,011.97 | $2,854.70 | $6,867.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.43 / $2,609.88 / $5,407.38
| Facility | | $1,636.43 | $2,609.88 | $5,407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $868.57 / $1,507.54 / $6,927.00
| Facility | | $868.57 | $1,507.54 | $6,927.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |