- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $4,241.22 / $12,765.09
| Facility | | $2,166.29 | $4,241.22 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,866.90 / $1,866.90 / $1,866.90
| Facility | 50 | $1,866.90 | $1,866.90 | $1,866.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.31 / $3,154.44 / $6,101.70
| Facility | | $2,398.31 | $3,154.44 | $6,101.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.02 / $958.78 / $6,817.20
| Facility | | $340.02 | $958.78 | $6,817.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.51 / $1,096.17 / $2,256.42
| Facility | | $727.51 | $1,096.17 | $2,256.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |