- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,407.00 / $4,500.00 / $7,045.00
| Facility | | $1,407.00 | $4,500.00 | $7,045.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.78 / $154.78 / $155.22
| Facility | | $154.78 | $154.78 | $155.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.62 / $122.70 / $300.51
| Facility | | $30.62 | $122.70 | $300.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.97 / $563.48 / $714.51
| Facility | | $335.97 | $563.48 | $714.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $457.07 / $845.22 / $1,114.25
| Facility | 50 | $457.07 | $845.22 | $1,114.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $1,800.00 / $9,193.00
| Facility | | $150.00 | $1,800.00 | $9,193.00 |