- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.00 / $2,540.00 / $6,681.00
| Facility | | $694.00 | $2,540.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,516.00 / $11,495.70 / $11,495.70
| Facility | 50 | $3,516.00 | $11,495.70 | $11,495.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,128.00 / $3,728.00 / $5,878.00
| Facility | | $2,128.00 | $3,728.00 | $5,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,219.76 / $9,388.90 / $26,542.00
| Facility | | $1,219.76 | $9,388.90 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $4,567.00 / $7,669.00
| Facility | | $2,000.00 | $4,567.00 | $7,669.00 |