- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,097.00 / $4,387.00 / $12,154.00
| Facility | | $1,097.00 | $4,387.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $415.25 / $2,195.53 / $2,195.53
| Facility | 50 | $415.25 | $2,195.53 | $2,195.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,080.00 / $2,357.90 / $2,482.00
| Facility | | $1,080.00 | $2,357.90 | $2,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,517.00 / $12,517.00 / $12,517.00
| Facility | | $12,517.00 | $12,517.00 | $12,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.35 / $1,200.00 / $16,394.00
| Facility | | $495.35 | $1,200.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.00 / $4,960.00 / $12,736.00
| Facility | | $1,967.00 | $4,960.00 | $12,736.00 |