- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.91 / $2,487.00 / $7,655.00
| Facility | | $534.91 | $2,487.00 | $7,655.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,522.00 / $2,522.00 / $2,522.00
| Facility | 50 | $2,522.00 | $2,522.00 | $2,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.00 / $1,322.90 / $1,705.26
| Facility | | $329.00 | $1,322.90 | $1,705.26 |
- 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
- $155.49 / $243.05 / $3,331.00
| Facility | | $155.49 | $243.05 | $3,331.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.00 / $2,081.00 / $3,918.00
| Facility | | $825.00 | $2,081.00 | $3,918.00 |