- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,424.15 / $3,252.75 / $3,955.04
| Facility | | $2,424.15 | $3,252.75 | $3,955.04 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,362.50 / $3,362.50 / $3,362.50
| Facility | 50 | $3,362.50 | $3,362.50 | $3,362.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.00 / $333.07 / $472.71
| Professional | | $247.00 | $333.07 | $472.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.37 / $456.24 / $629.54
| Professional | | $319.37 | $456.24 | $629.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.00 / $494.86 / $772.72
| Professional | | $250.00 | $494.86 | $772.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,654.00 / $3,447.00 / $7,350.00
| Facility | | $2,654.00 | $3,447.00 | $7,350.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.85 / $535.62 / $787.15
| Professional | | $364.85 | $535.62 | $787.15 |