- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.01 / $2,876.83 / $9,359.12
| Facility | | $143.01 | $2,876.83 | $9,359.12 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,782.40 / $1,782.40 / $4,565.56
| Facility | 50 | $1,782.40 | $1,782.40 | $4,565.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,840.00 / $7,747.00
| Facility | | $1,636.00 | $3,840.00 | $7,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.22 / $197.96 / $296.94
| Facility | | $144.22 | $197.96 | $296.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.45 / $1,123.45 / $1,331.74
| Facility | | $1,123.45 | $1,123.45 | $1,331.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,874.00 / $5,490.00
| Facility | | $2,400.00 | $3,874.00 | $5,490.00 |