- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.18 / $9,062.00 / $18,276.00
| Facility | | $238.18 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.71 / $5,671.88 / $9,876.36
| Facility | | $2,777.71 | $5,671.88 | $9,876.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $715.00 / $715.00
| Facility | | $715.00 | $715.00 | $715.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.32 / $291.00 / $680.00
| Facility | | $218.32 | $291.00 | $680.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $268.45 / $436.50 / $1,494.00
| Facility | 50 | $268.45 | $436.50 | $1,494.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |