- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,400.00 / $3,697.00 / $8,684.28
| Facility | | $1,400.00 | $3,697.00 | $8,684.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,234.92 / $7,234.92 / $7,234.92
| Facility | 50 | $7,234.92 | $7,234.92 | $7,234.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.00 / $4,247.00 / $9,663.00
| Facility | | $2,088.00 | $4,247.00 | $9,663.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.16 / $693.66 / $10,868.80
| Facility | | $350.16 | $693.66 | $10,868.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,748.00 / $3,502.00 / $6,854.00
| Facility | | $1,748.00 | $3,502.00 | $6,854.00 |