- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.79 / $3,809.00 / $8,321.00
| Facility | | $730.79 | $3,809.00 | $8,321.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,406.63 / $7,787.24 / $11,053.99
| Facility | 50 | $3,406.63 | $7,787.24 | $11,053.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,393.00 / $4,120.00 / $8,800.00
| Facility | | $2,393.00 | $4,120.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $1,000.00 / $3,600.34
| Facility | | $875.00 | $1,000.00 | $3,600.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $3,857.50 / $7,911.50
| Facility | | $1,981.00 | $3,857.50 | $7,911.50 |