- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.70 / $4,261.00 / $11,271.00
| Facility | | $303.70 | $4,261.00 | $11,271.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $872.75 / $872.75 / $872.75
| Facility | 50 | $872.75 | $872.75 | $872.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.00 / $4,449.00 / $10,043.00
| Facility | | $2,224.00 | $4,449.00 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.00 / $13,106.00 / $17,811.00
| Facility | | $11,533.00 | $13,106.00 | $17,811.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $233.62 / $478.21 / $21,814.90
| Facility | | $233.62 | $478.21 | $21,814.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,318.00 / $5,740.00
| Facility | | $2,155.00 | $3,318.00 | $5,740.00 |