- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,165.00 / $6,770.00 / $11,243.00
| Facility | | $1,165.00 | $6,770.00 | $11,243.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,657.36 / $2,657.36 / $3,931.56
| Facility | 50 | $2,657.36 | $2,657.36 | $3,931.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,576.00 / $14,996.00
| Facility | | $1,760.00 | $3,576.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.35 / $407.22 / $636.29
| Facility | | $339.35 | $407.22 | $636.29 |
- 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
- $3,247.33 / $3,247.33 / $3,247.33
| Facility | | $3,247.33 | $3,247.33 | $3,247.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,647.00 / $4,410.00 / $7,351.00
| Facility | | $2,647.00 | $4,410.00 | $7,351.00 |