- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.46 / $4,516.00 / $9,784.00
| Facility | | $440.46 | $4,516.00 | $9,784.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,715.00 / $3,715.00 / $3,715.00
| Facility | 50 | $3,715.00 | $3,715.00 | $3,715.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,438.00 / $3,438.00 / $3,438.00
| Facility | | $3,438.00 | $3,438.00 | $3,438.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,075.85 / $14,882.11 / $18,183.06
| Facility | | $8,075.85 | $14,882.11 | $18,183.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,567.00 / $7,263.00 / $10,536.00
| Facility | | $4,567.00 | $7,263.00 | $10,536.00 |