- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.00 / $4,376.00 / $12,154.00
| Facility | | $883.00 | $4,376.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,509.40 / $1,723.15 / $2,357.84
| Facility | 50 | $1,509.40 | $1,723.15 | $2,357.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,319.21 / $2,943.50 / $4,020.08
| Facility | | $1,319.21 | $2,943.50 | $4,020.08 |
- 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
- $179.59 / $364.66 / $6,863.75
| Facility | | $179.59 | $364.66 | $6,863.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,125.00 / $6,026.00
| Facility | | $1,436.00 | $3,125.00 | $6,026.00 |