- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.91 / $637.00 / $2,747.00
| Facility | | $171.91 | $637.00 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $921.00 / $2,562.71 / $3,877.00
| Facility | 50 | $921.00 | $2,562.71 | $3,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,517.00
| Facility | | $1,643.00 | $3,498.00 | $8,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.30 / $233.76 / $269.64
| Facility | | $170.30 | $233.76 | $269.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.04 / $204.04 / $244.02
| Facility | | $204.04 | $204.04 | $244.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |