- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.75 / $2,652.00 / $12,600.00
| Facility | | $730.75 | $2,652.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $977.25 / $2,238.37 / $3,761.65
| Facility | 50 | $977.25 | $2,238.37 | $3,761.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,599.13 / $11,846.28 / $18,641.72
| Facility | | $7,599.13 | $11,846.28 | $18,641.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.29 / $637.75 / $5,962.62
| Facility | | $201.29 | $637.75 | $5,962.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,270.83 / $1,270.83 / $1,270.83
| Facility | 50 | $1,270.83 | $1,270.83 | $1,270.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $2,875.93 / $5,543.93
| Facility | | $884.00 | $2,875.93 | $5,543.93 |