- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $14,454.40 / $19,952.62
| Facility | | $1,148.15 | $14,454.40 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,691.53 / $6,606.93 / $13,803.84
| Facility | 50 | $2,691.53 | $6,606.93 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,135.61 / $26,302.68
| Facility | | $10,715.19 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,698.24 / $2,691.53
| Facility | | $1,445.44 | $1,698.24 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,621.81 / $5,754.40
| Facility | | $512.86 | $1,621.81 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,659.59 / $15,848.93
| Facility | | $549.54 | $1,659.59 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,818.38 / $5,128.61 / $7,413.10
| Facility | 50 | $2,818.38 | $5,128.61 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,230.27 / $1,819.70
| Professional | | $891.25 | $1,230.27 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $19,952.62 / $19,952.62
| Facility | | $13,489.63 | $19,952.62 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,595.87
| Facility | | $7,585.78 | $12,302.69 | $16,595.87 |