- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.58 / $612.00 / $8,229.00
| Facility | | $310.58 | $612.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,557.94 / $1,557.94 / $3,847.20
| Facility | 50 | $1,557.94 | $1,557.94 | $3,847.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,517.00
| Facility | | $1,643.00 | $3,498.00 | $8,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.26 / $425.84 / $491.23
| Facility | | $311.26 | $425.84 | $491.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.17 / $373.54 / $373.54
| Facility | | $341.17 | $373.54 | $373.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |