- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.00 / $4,538.00 / $11,550.00
| Facility | | $630.00 | $4,538.00 | $11,550.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,197.50 / $1,197.50 / $4,099.89
| Facility | 50 | $1,197.50 | $1,197.50 | $4,099.89 |
- 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
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |