- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.27 / $226.33 / $10,561.00
| Facility | | $0.27 | $226.33 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.62 / $185.15 / $480.00
| Facility | | $175.62 | $185.15 | $480.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $263.43 / $277.73 / $772.50
| Facility | 50 | $263.43 | $277.73 | $772.50 |
- 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
- $428.23 / $2,538.00 / $26,542.00
| Facility | | $428.23 | $2,538.00 | $26,542.00 |