- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.62 / $2,547.00 / $10,635.00
| Facility | | $203.62 | $2,547.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $17,717.12 / $17,717.12 / $17,717.12
| Facility | 50 | $17,717.12 | $17,717.12 | $17,717.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.96 / $171.77 / $216.84
| Facility | | $117.96 | $171.77 | $216.84 |
- 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
- $444.00 / $979.00 / $3,218.00
| Facility | | $444.00 | $979.00 | $3,218.00 |