- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.85 / $2,306.00 / $10,268.00
| Facility | | $149.85 | $2,306.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,112.00 / $3,087.00 / $3,087.00
| Facility | 50 | $2,112.00 | $3,087.00 | $3,087.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,786.00 / $8,800.00
| Facility | | $1,145.00 | $2,786.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.65 / $93.18 / $145.59
| Facility | | $77.65 | $93.18 | $145.59 |
- 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
- $1,725.00 / $2,721.00 / $5,235.00
| Facility | | $1,725.00 | $2,721.00 | $5,235.00 |