- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.49 / $812.49 / $812.49
| Facility | | $812.49 | $812.49 | $812.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.43 / $2,110.42 / $6,126.01
| Facility | | $816.43 | $2,110.42 | $6,126.01 |
- 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
- $1,797.39 / $2,548.92 / $6,131.78
| Facility | | $1,797.39 | $2,548.92 | $6,131.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.15 / $2,330.33 / $4,828.18
| Facility | | $1,461.15 | $2,330.33 | $4,828.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,201.54 / $1,486.77 / $3,500.00
| Facility | | $1,201.54 | $1,486.77 | $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 |