- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $974.00 / $2,794.39 / $7,602.00
| Facility | | $974.00 | $2,794.39 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,518.50 / $5,518.50 / $5,518.50
| Facility | 50 | $5,518.50 | $5,518.50 | $5,518.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,652.00 / $3,053.00 / $4,630.00
| Facility | | $1,652.00 | $3,053.00 | $4,630.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,013.28 / $4,129.97 / $26,542.00
| Facility | | $4,013.28 | $4,129.97 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,064.00 / $3,728.00 / $7,371.00
| Facility | | $2,064.00 | $3,728.00 | $7,371.00 |