- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,513.56 / $4,570.88
| Facility | | $831.76 | $1,513.56 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $758.58 / $3,090.30 / $4,677.35
| Facility | 50 | $758.58 | $3,090.30 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,168.69
| Facility | 80 | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $5,248.07 / $7,079.46
| Facility | | $4,466.84 | $5,248.07 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,606.93 / $7,943.28 / $10,715.19
| Facility | 50 | $6,606.93 | $7,943.28 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $3,630.78 / $5,370.32
| Facility | | $1,122.02 | $3,630.78 | $5,370.32 |