- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.87 / $2,508.50 / $7,843.00
| Facility | | $532.87 | $2,508.50 | $7,843.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $687.00 / $2,618.25 / $5,739.00
| Facility | 50 | $687.00 | $2,618.25 | $5,739.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.00 / $1,963.00 / $4,958.00
| Facility | | $821.00 | $1,963.00 | $4,958.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.53 / $1,639.07 / $26,542.00
| Facility | | $482.53 | $1,639.07 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,934.00 / $8,934.00 / $8,934.00
| Facility | 50 | $8,934.00 | $8,934.00 | $8,934.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,156.00 / $4,000.00 / $10,781.00
| Facility | | $2,156.00 | $4,000.00 | $10,781.00 |