- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.02 / $2,243.00 / $5,691.00
| Facility | | $213.02 | $2,243.00 | $5,691.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,493.00 / $5,493.00 / $5,493.00
| Facility | 50 | $5,493.00 | $5,493.00 | $5,493.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.00 / $1,963.00 / $4,852.00
| Facility | | $821.00 | $1,963.00 | $4,852.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.19 / $233.24 / $4,754.80
| Facility | | $143.19 | $233.24 | $4,754.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,216.00 / $2,306.00 / $3,071.00
| Facility | | $1,216.00 | $2,306.00 | $3,071.00 |