- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.04 / $5,154.85 / $16,387.32
| Facility | | $229.04 | $5,154.85 | $16,387.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,271.20 / $15,429.88 / $15,429.88
| Facility | 50 | $8,271.20 | $15,429.88 | $15,429.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.56 / $255.02 / $308.72
| Facility | | $209.56 | $255.02 | $308.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.11 / $242.11 / $242.11
| Facility | | $242.11 | $242.11 | $242.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,691.65 / $10,691.65 / $13,984.94
| Facility | | $10,691.65 | $10,691.65 | $13,984.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,899.60 / $9,899.60 / $11,808.92
| Facility | 50 | $9,899.60 | $9,899.60 | $11,808.92 |