- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.23 / $2,967.00 / $7,900.64
| Facility | | $89.23 | $2,967.00 | $7,900.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,444.28 / $2,444.28 / $2,444.28
| Facility | 50 | $2,444.28 | $2,444.28 | $2,444.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,529.00 / $2,971.00 / $4,707.00
| Facility | | $1,529.00 | $2,971.00 | $4,707.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $568.48 / $721.90
| Facility | | $395.75 | $568.48 | $721.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $788.00 / $1,940.00 / $4,067.00
| Facility | | $788.00 | $1,940.00 | $4,067.00 |