- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.78 / $2,303.00 / $7,602.00
| Facility | | $667.78 | $2,303.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,442.00 / $18,800.55 / $18,800.55
| Facility | 50 | $2,442.00 | $18,800.55 | $18,800.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,676.00 / $3,611.00 / $5,878.00
| Facility | | $1,676.00 | $3,611.00 | $5,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,413.08 / $8,723.79 / $12,000.00
| Facility | | $2,413.08 | $8,723.79 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,259.00 / $4,567.00 / $7,669.00
| Facility | | $2,259.00 | $4,567.00 | $7,669.00 |