- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $394.34 / $5,706.00 / $10,268.00
| Facility | | $394.34 | $5,706.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $652.26 / $3,133.79 / $6,554.00
| Facility | 50 | $652.26 | $3,133.79 | $6,554.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,895.00 / $5,211.00 / $29,406.00
| Facility | | $1,895.00 | $5,211.00 | $29,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.74 / $264.89 / $413.90
| Facility | | $220.74 | $264.89 | $413.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,904.00 / $6,111.00 / $9,245.00
| Facility | | $2,904.00 | $6,111.00 | $9,245.00 |