- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.56 / $878.00 / $6,906.00
| Facility | | $246.56 | $878.00 | $6,906.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,426.99 / $1,663.21 / $2,253.38
| Facility | | $1,426.99 | $1,663.21 | $2,253.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $764.64 / $1,126.69 / $1,448.55
| Facility | 50 | $764.64 | $1,126.69 | $1,448.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.56 / $319.45 / $6,906.00
| Facility | | $246.56 | $319.45 | $6,906.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $1,386.00 / $2,449.00
| Facility | | $300.00 | $1,386.00 | $2,449.00 |