- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,713.43 / $5,620.72 / $14,265.15
| Facility | | $1,713.43 | $5,620.72 | $14,265.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,353.68 / $5,904.80 / $27,637.59
| Facility | 50 | $3,353.68 | $5,904.80 | $27,637.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.89 / $1,551.76 / $1,909.82
| Facility | | $1,148.89 | $1,551.76 | $1,909.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,803.07 / $15,339.80 / $19,820.41
| Facility | | $7,803.07 | $15,339.80 | $19,820.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,127.92 / $23,009.70 / $30,811.46
| Facility | 50 | $11,127.92 | $23,009.70 | $30,811.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,360.00 / $16,762.00 / $17,870.00
| Facility | | $9,360.00 | $16,762.00 | $17,870.00 |