- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,549.00 / $5,760.95
| Facility | | $900.00 | $2,549.00 | $5,760.95 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,522.50 / $8,522.50 / $26,549.16
| Facility | 50 | $8,522.50 | $8,522.50 | $26,549.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,055.03 / $9,225.49 / $12,849.85
| Facility | | $5,055.03 | $9,225.49 | $12,849.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.21 / $7,413.21 / $7,413.21
| Facility | | $7,413.21 | $7,413.21 | $7,413.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,141.00 / $4,717.00 / $10,810.00
| Facility | | $1,141.00 | $4,717.00 | $10,810.00 |