- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.00 / $3,051.00 / $12,015.79
| Facility | | $941.00 | $3,051.00 | $12,015.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $13,686.00 / $13,686.00 / $13,686.00
| Facility | 50 | $13,686.00 | $13,686.00 | $13,686.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,898.80 / $10,230.67 / $14,577.45
| Facility | | $5,898.80 | $10,230.67 | $14,577.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.70 / $7,155.23 / $7,155.23
| Facility | | $870.70 | $7,155.23 | $7,155.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.00 / $1,802.00 / $1,802.00
| Facility | | $1,802.00 | $1,802.00 | $1,802.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $5,780.00 / $13,506.00
| Facility | | $1,200.00 | $5,780.00 | $13,506.00 |