- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.45 / $2,131.00 / $6,762.00
| Facility | | $573.45 | $2,131.00 | $6,762.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,530.00 / $3,373.50 / $6,485.51
| Facility | 50 | $1,530.00 | $3,373.50 | $6,485.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,605.41 / $4,786.68 / $9,694.56
| Facility | | $2,605.41 | $4,786.68 | $9,694.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.69 / $523.69 / $577.54
| Facility | | $523.69 | $523.69 | $577.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,207.78 / $2,207.78 / $2,207.78
| Facility | | $2,207.78 | $2,207.78 | $2,207.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,723.79 / $12,000.00 / $12,000.00
| Facility | | $8,723.79 | $12,000.00 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.69 / $757.83 / $1,384.54
| Facility | | $599.69 | $757.83 | $1,384.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.69 / $770.18 / $1,386.36
| Facility | | $599.69 | $770.18 | $1,386.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |