- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $3,388.44 / $5,370.32
| Facility | | $1,202.26 | $3,388.44 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.83 / $0.83 / $0.83
| Facility | 50 | $0.83 | $0.83 | $0.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,071.52 / $7,244.36
| Facility | | $467.74 | $1,071.52 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $707.95 / $7,079.46
| Facility | | $165.96 | $707.95 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $3,467.37
| Facility | | $501.19 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.81 / $0.81 / $0.81
| Facility | | $0.81 | $0.81 | $0.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,819.70 / $7,244.36
| Facility | | $489.78 | $1,819.70 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $2,818.38
| Facility | | $501.19 | $1,862.09 | $2,818.38 |