- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.66 / $1,517.00 / $9,034.00
| Facility | | $810.66 | $1,517.00 | $9,034.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,083.00 / $1,083.00 / $1,083.00
| Facility | 50 | $1,083.00 | $1,083.00 | $1,083.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,555.03 / $3,555.03 / $4,266.04
| Facility | | $3,555.03 | $3,555.03 | $4,266.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.30 / $2,368.30 / $2,368.30
| Facility | | $2,368.30 | $2,368.30 | $2,368.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.00 / $2,268.00 / $5,626.00
| Facility | | $1,240.00 | $2,268.00 | $5,626.00 |