- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.06 / $1,020.06 / $1,020.06
| Facility | | $1,020.06 | $1,020.06 | $1,020.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.43 / $2,110.42 / $7,723.43
| Facility | | $816.43 | $2,110.42 | $7,723.43 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,432.44 / $2,173.33 / $3,810.74
| Facility | 50 | $1,432.44 | $2,173.33 | $3,810.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,257.27 / $3,201.09 / $7,700.65
| Facility | | $2,257.27 | $3,201.09 | $7,700.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,835.00 / $2,926.56 / $6,063.50
| Facility | | $1,835.00 | $2,926.56 | $6,063.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,478.77 / $1,868.11 / $3,500.00
| Facility | | $1,478.77 | $1,868.11 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |