- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,949.84 / $8,317.64
| Facility | | $489.78 | $1,949.84 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,230.27 / $8,709.64 / $15,848.93
| Facility | 50 | $1,230.27 | $8,709.64 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $933.25 / $1,318.26
| Facility | | $933.25 | $933.25 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $602.56 / $724.44
| Professional | | $501.19 | $602.56 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $660.69
| Professional | | $501.19 | $501.19 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $512.86 / $794.33
| Facility | | $295.12 | $512.86 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $549.54 / $8,709.64
| Facility | | $275.42 | $549.54 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,244.36 / $14,125.38
| Facility | | $3,890.45 | $7,244.36 | $14,125.38 |