- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.00 / $3,276.00 / $11,550.00
| Facility | | $407.00 | $3,276.00 | $11,550.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,169.91 / $3,169.91 / $3,169.91
| Facility | 50 | $3,169.91 | $3,169.91 | $3,169.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $956.77 / $1,139.02
| Facility | | $323.00 | $956.77 | $1,139.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,144.00 / $5,731.00 / $11,037.00
| Facility | | $3,144.00 | $5,731.00 | $11,037.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $3,611.00 / $8,105.00
| Facility | | $803.00 | $3,611.00 | $8,105.00 |