- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.68 / $2,678.00 / $7,602.00
| Facility | | $884.68 | $2,678.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $770.50 / $1,286.26 / $6,323.45
| Facility | 50 | $770.50 | $1,286.26 | $6,323.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,367.00 / $5,500.00 / $9,419.00
| Facility | | $2,367.00 | $5,500.00 | $9,419.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,749.74 / $13,759.35 / $13,759.35
| Facility | | $2,749.74 | $13,759.35 | $13,759.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,259.00 / $4,567.00 / $7,669.00
| Facility | | $2,259.00 | $4,567.00 | $7,669.00 |