- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.09 / $2,056.00 / $4,933.00
| Facility | | $762.09 | $2,056.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,815.12 / $3,286.09 / $4,476.56
| Facility | | $2,815.12 | $3,286.09 | $4,476.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,779.24 / $2,302.14 / $3,035.22
| Facility | 50 | $1,779.24 | $2,302.14 | $3,035.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.37 / $2,056.00 / $4,933.00
| Facility | | $659.37 | $2,056.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,296.00 / $7,849.00 / $9,202.00
| Facility | | $3,296.00 | $7,849.00 | $9,202.00 |