- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.69 / $2,056.00 / $4,933.00
| Facility | | $105.69 | $2,056.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,589.12 / $1,854.99 / $2,527.00
| Facility | | $1,589.12 | $1,854.99 | $2,527.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,004.38 / $1,299.55 / $1,645.36
| Facility | 50 | $1,004.38 | $1,299.55 | $1,645.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.32 / $2,056.00 / $4,933.00
| Facility | | $567.32 | $2,056.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,493.26 / $3,569.00 / $6,327.00
| Facility | | $1,493.26 | $3,569.00 | $6,327.00 |