- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.89 / $2,095.00 / $8,763.29
| Facility | | $821.89 | $2,095.00 | $8,763.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,387.88 / $11,686.50 / $11,686.50
| Facility | 50 | $1,387.88 | $11,686.50 | $11,686.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,372.96 / $8,216.95 / $12,750.76
| Facility | | $2,372.96 | $8,216.95 | $12,750.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,700.00 / $2,700.00 / $2,700.00
| Facility | | $2,700.00 | $2,700.00 | $2,700.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.85 / $712.78 / $2,000.00
| Facility | | $521.85 | $712.78 | $2,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.00 / $5,971.00 / $8,422.00
| Facility | | $639.00 | $5,971.00 | $8,422.00 |