- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $2,260.00 / $5,506.00
| Facility | | $936.00 | $2,260.00 | $5,506.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,623.00 / $1,623.00 / $8,055.00
| Facility | 50 | $1,623.00 | $1,623.00 | $8,055.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.60 / $1,640.88 / $2,700.74
| Facility | | $438.60 | $1,640.88 | $2,700.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.02 / $197.38 / $3,134.00
| Facility | | $150.02 | $197.38 | $3,134.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.00 / $2,567.00 / $5,029.00
| Facility | | $1,584.00 | $2,567.00 | $5,029.00 |