- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,667.52 / $4,933.00 / $4,933.00
| Facility | | $1,667.52 | $4,933.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,225.70 / $7,256.27 / $9,831.09
| Facility | | $6,225.70 | $7,256.27 | $9,831.09 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,907.45 / $4,551.96 / $6,665.74
| Facility | 50 | $3,907.45 | $4,551.96 | $6,665.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.18 / $4,933.00 / $4,933.00
| Facility | | $1,341.18 | $4,933.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,906.00 / $4,645.00 / $6,327.00
| Facility | | $1,906.00 | $4,645.00 | $6,327.00 |