- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.44 / $1,397.00 / $3,109.00
| Facility | | $626.44 | $1,397.00 | $3,109.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $438.50 / $867.00 / $944.10
| Facility | 50 | $438.50 | $867.00 | $944.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,292.46 / $6,292.46 / $7,550.95
| Facility | | $6,292.46 | $6,292.46 | $7,550.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,953.80 / $2,953.80 / $2,953.80
| Facility | | $2,953.80 | $2,953.80 | $2,953.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.00 / $2,311.00 / $5,652.00
| Facility | | $1,240.00 | $2,311.00 | $5,652.00 |