- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $764.65 / $1,517.00 / $9,034.00
| Facility | | $764.65 | $1,517.00 | $9,034.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,624.50 / $1,624.50 / $1,624.50
| Facility | 50 | $1,624.50 | $1,624.50 | $1,624.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,150.23 / $2,150.23 / $2,580.29
| Facility | | $2,150.23 | $2,150.23 | $2,580.29 |
- 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
- $980.00 / $1,650.00 / $4,064.00
| Facility | | $980.00 | $1,650.00 | $4,064.00 |