- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.12 / $3,706.14 / $8,644.27
| Facility | | $851.12 | $3,706.14 | $8,644.27 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,551.25 / $5,551.25 / $6,259.25
| Facility | 50 | $5,551.25 | $5,551.25 | $6,259.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,385.00 / $4,133.00 / $9,074.00
| Facility | | $2,385.00 | $4,133.00 | $9,074.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $971.41 / $996.00 / $1,217.48
| Facility | | $971.41 | $996.00 | $1,217.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.00 / $4,029.00 / $7,389.05
| Facility | | $1,763.00 | $4,029.00 | $7,389.05 |