- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.00 / $2,266.00 / $7,119.04
| Facility | | $391.00 | $2,266.00 | $7,119.04 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,661.00 / $2,661.00 / $3,991.50
| Facility | 50 | $2,661.00 | $2,661.00 | $3,991.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.00 / $4,517.00 / $9,381.00
| Facility | | $2,224.00 | $4,517.00 | $9,381.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.36 / $291.36 / $4,249.64
| Facility | | $291.36 | $291.36 | $4,249.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.00 / $1,221.00 / $2,883.00
| Facility | | $444.00 | $1,221.00 | $2,883.00 |