- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.88 / $1,728.00 / $5,688.50
| Facility | | $70.88 | $1,728.00 | $5,688.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $706.70 / $782.13 / $875.42
| Facility | 50 | $706.70 | $782.13 | $875.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,529.00 / $2,479.00 / $4,441.52
| Facility | | $1,529.00 | $2,479.00 | $4,441.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.44 / $184.67 / $330.00
| Facility | | $141.44 | $184.67 | $330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.50 / $1,068.00 / $2,694.00
| Facility | | $325.50 | $1,068.00 | $2,694.00 |