- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $386.65 / $963.50 / $2,160.10
| Facility | | $386.65 | $963.50 | $2,160.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $867.00 / $944.10 / $1,325.36
| Facility | 50 | $867.00 | $944.10 | $1,325.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,464.66 / $2,464.66 / $2,464.66
| Facility | | $2,464.66 | $2,464.66 | $2,464.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,509.58 / $2,509.58 / $5,339.84
| Facility | | $2,509.58 | $2,509.58 | $5,339.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $2,717.00 / $7,175.00
| Facility | | $860.00 | $2,717.00 | $7,175.00 |