- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.87 / $5,291.00 / $11,576.00
| Facility | | $151.87 | $5,291.00 | $11,576.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.51 / $0.51 / $0.51
| Facility | 50 | $0.51 | $0.51 | $0.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.00 / $611.00 / $630.00
| Facility | | $611.00 | $611.00 | $630.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.82 / $1,029.38 / $1,798.82
| Facility | | $831.82 | $1,029.38 | $1,798.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.00 / $1,911.00 / $4,970.00
| Facility | | $345.00 | $1,911.00 | $4,970.00 |