- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.36 / $1,821.00 / $6,681.00
| Facility | | $83.36 | $1,821.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $427.80 / $427.80 / $427.80
| Facility | 50 | $427.80 | $427.80 | $427.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $764.00 / $1,504.00 / $2,244.00
| Facility | | $764.00 | $1,504.00 | $2,244.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.77 / $259.77 / $12,000.00
| Facility | | $259.77 | $259.77 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.00 / $794.00 / $2,495.00
| Facility | | $267.00 | $794.00 | $2,495.00 |