- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $1,698.24
| Facility | | $229.09 | $229.09 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Facility | 50 | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $302.00
| Facility | | $245.47 | $245.47 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $1,862.09
| Facility | | $398.11 | $398.11 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $18,197.01 / $18,197.01
| Facility | | $18,197.01 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $1,202.26
| Facility | 50 | $1,202.26 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $2,884.03 / $19,498.45
| Facility | | $2,884.03 | $2,884.03 | $19,498.45 |