- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.95 / $1,386.00 / $5,634.00
| Facility | | $534.95 | $1,386.00 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,609.73 / $6,609.73 / $6,609.73
| Facility | 50 | $6,609.73 | $6,609.73 | $6,609.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,950.00 / $15,154.00
| Facility | | $1,682.00 | $3,950.00 | $15,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $621.25 / $877.07 / $1,315.61
| Facility | | $621.25 | $877.07 | $1,315.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,061.25 / $2,061.25 / $2,061.25
| Facility | | $2,061.25 | $2,061.25 | $2,061.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |