- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $1,513.56 / $2,137.96
| Facility | | $389.05 | $1,513.56 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $870.96 / $954.99 / $4,466.84
| Facility | 50 | $870.96 | $954.99 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $2,454.71
| Facility | | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $5,370.32
| Facility | | $2,511.89 | $2,511.89 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,467.37 / $9,332.54
| Facility | | $851.14 | $3,467.37 | $9,332.54 |