- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.54 / $4,500.00 / $10,839.84
| Facility | | $368.54 | $4,500.00 | $10,839.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,006.37 / $1,006.37 / $1,009.20
| Facility | | $1,006.37 | $1,006.37 | $1,009.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.88 / $281.68 / $371.64
| Facility | | $142.88 | $281.68 | $371.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,702.95 / $3,860.69 / $4,869.63
| Facility | | $2,702.95 | $3,860.69 | $4,869.63 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,051.74 / $5,791.04 / $7,593.87
| Facility | 50 | $4,051.74 | $5,791.04 | $7,593.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $3,450.00 / $7,609.00
| Facility | | $675.00 | $3,450.00 | $7,609.00 |