- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.00 / $1,243.26 / $2,010.00
| Facility | | $750.00 | $1,243.26 | $2,010.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,217.50 / $7,217.50 / $52,214.18
| Facility | 50 | $7,217.50 | $7,217.50 | $52,214.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,453.97 / $1,453.97 / $1,453.97
| Facility | | $1,453.97 | $1,453.97 | $1,453.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,591.14 / $1,591.14 / $5,238.99
| Facility | | $1,591.14 | $1,591.14 | $5,238.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $2,717.00 / $7,175.00
| Facility | | $860.00 | $2,717.00 | $7,175.00 |