- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.55 / $481.62 / $10,561.00
| Facility | | $0.55 | $481.62 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.46 / $291.00 / $860.43
| Facility | | $189.46 | $291.00 | $860.43 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $306.00 / $436.50 / $1,618.50
| Facility | 50 | $306.00 | $436.50 | $1,618.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.00 / $896.00 / $2,229.00
| Facility | | $361.00 | $896.00 | $2,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $698.78 / $2,538.00 / $26,542.00
| Facility | | $698.78 | $2,538.00 | $26,542.00 |