- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $2,398.83 / $12,589.25
| Facility | | $275.42 | $2,398.83 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $169.82 / $269.15
| Facility | | $169.82 | $169.82 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Facility | 50 | $257.04 | $257.04 | $257.04 |