- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $322.00 / $2,202.00 / $5,506.00
| Facility | | $322.00 | $2,202.00 | $5,506.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $896.00 / $896.00 / $896.00
| Facility | 50 | $896.00 | $896.00 | $896.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.80 / $1,640.88 / $2,700.74
| Facility | | $412.80 | $1,640.88 | $2,700.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.30 / $123.24 / $1,117.00
| Facility | | $31.30 | $123.24 | $1,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.00 / $1,423.00 / $2,114.00
| Facility | | $683.00 | $1,423.00 | $2,114.00 |