- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.20 / $1,812.94 / $1,812.94
| Facility | | $407.20 | $1,812.94 | $1,812.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $652.26 / $1,817.40 / $6,904.77
| Facility | 50 | $652.26 | $1,817.40 | $6,904.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $399.96 / $446.23 / $486.19
| Facility | | $399.96 | $446.23 | $486.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.40 / $429.40 / $429.40
| Facility | | $429.40 | $429.40 | $429.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,365.86 / $14,365.86 / $15,265.73
| Facility | | $14,365.86 | $14,365.86 | $15,265.73 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,677.93 / $6,102.68 / $14,025.38
| Facility | 50 | $1,677.93 | $6,102.68 | $14,025.38 |