- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.00 / $6,560.00 / $13,151.00
| Facility | | $1,023.00 | $6,560.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $982.25 / $1,640.70 / $4,212.50
| Facility | 50 | $982.25 | $1,640.70 | $4,212.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.00 / $11,533.00 / $11,533.00
| Facility | | $11,533.00 | $11,533.00 | $11,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.82 / $1,833.00 / $5,897.00
| Facility | | $498.82 | $1,833.00 | $5,897.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,946.00 / $7,504.00
| Facility | | $1,779.00 | $3,946.00 | $7,504.00 |