- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $5,623.41 / $16,595.87
| Facility | | $1,862.09 | $5,623.41 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | 50 | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $6,456.54 / $9,772.37
| Facility | | $2,754.23 | $6,456.54 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,168.69
| Facility | | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $18,197.01 / $50,118.72
| Facility | | $18,197.01 | $18,197.01 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $8,317.64 / $13,182.57
| Facility | | $4,265.80 | $8,317.64 | $13,182.57 |