- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.20 / $3,232.00 / $10,439.00
| Facility | | $116.20 | $3,232.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $855.91 / $1,312.00 / $1,312.00
| Facility | 50 | $855.91 | $1,312.00 | $1,312.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.00 / $330.00 / $330.00
| Facility | | $330.00 | $330.00 | $330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.90 / $129.38 / $611.00
| Facility | | $32.90 | $129.38 | $611.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.81 / $500.00 / $1,907.00
| Facility | | $167.81 | $500.00 | $1,907.00 |