- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.18 / $643.11 / $2,747.00
| Facility | | $361.18 | $643.11 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $153.00 / $153.00 / $7,775.09
| Facility | 50 | $153.00 | $153.00 | $7,775.09 |
- 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
- $355.52 / $487.97 / $562.91
| Facility | | $355.52 | $487.97 | $562.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.40 / $429.40 / $649.60
| Facility | | $429.40 | $429.40 | $649.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |