- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.14 / $6,028.50 / $8,450.69
| Facility | | $19.14 | $6,028.50 | $8,450.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $14,033.66 / $14,033.66 / $14,033.66
| Facility | 50 | $14,033.66 | $14,033.66 | $14,033.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,335.00 / $1,335.00 / $3,314.62
| Facility | | $1,335.00 | $1,335.00 | $3,314.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,363.53 / $1,782.39 / $2,296.46
| Professional | | $1,363.53 | $1,782.39 | $2,296.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,003.00 / $1,003.00 / $2,156.00
| Facility | | $1,003.00 | $1,003.00 | $2,156.00 |