- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $4,350.00 / $13,200.00
| Facility | | $1,300.00 | $4,350.00 | $13,200.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $78.56 / $78.56 / $78.56
| Facility | 50 | $78.56 | $78.56 | $78.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,464.88 / $8,620.91 / $13,717.10
| Facility | | $5,464.88 | $8,620.91 | $13,717.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.60 / $754.51 / $6,698.00
| Facility | | $473.60 | $754.51 | $6,698.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $880.00 / $2,900.00 / $5,543.93
| Facility | | $880.00 | $2,900.00 | $5,543.93 |