- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.98 / $9,062.00 / $18,276.00
| Facility | | $234.98 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,170.88 / $5,992.88 / $9,876.36
| Facility | | $3,170.88 | $5,992.88 | $9,876.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.00 / $193.52 / $338.00
| Facility | | $139.00 | $193.52 | $338.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $208.50 / $274.50 / $580.03
| Facility | 50 | $208.50 | $274.50 | $580.03 |
- 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 |