- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.00 / $3,497.20 / $10,086.00
| Facility | | $714.00 | $3,497.20 | $10,086.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,124.39 / $4,124.39 / $12,734.06
| Facility | 50 | $4,124.39 | $4,124.39 | $12,734.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $1,649.96 / $1,964.23
| Facility | | $323.00 | $1,649.96 | $1,964.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,571.00 / $12,685.00 / $23,031.00
| Facility | | $5,571.00 | $12,685.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,681.00 / $5,811.00 / $10,057.00
| Facility | | $1,681.00 | $5,811.00 | $10,057.00 |