- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,407.00 / $4,500.00 / $7,045.00
| Facility | | $1,407.00 | $4,500.00 | $7,045.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.29 / $446.29 / $447.54
| Facility | | $446.29 | $446.29 | $447.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.11 / $218.85 / $638.07
| Facility | | $80.11 | $218.85 | $638.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,246.64 / $1,753.89 / $2,148.87
| Facility | | $1,246.64 | $1,753.89 | $2,148.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,846.65 / $2,630.84 / $3,267.48
| Facility | 50 | $1,846.65 | $2,630.84 | $3,267.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $2,620.00 / $4,441.00
| Facility | | $450.00 | $2,620.00 | $4,441.00 |