- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $2,344.23 / $5,128.61
| Facility | | $562.34 | $2,344.23 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,089.30 / $2,089.30 / $8,317.64
| Facility | 50 | $2,089.30 | $2,089.30 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,754.40 / $19,498.45
| Facility | | $1,548.82 | $5,754.40 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,288.25 / $7,079.46
| Facility | | $380.19 | $1,288.25 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $933.25 / $1,584.89
| Facility | | $933.25 | $933.25 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $5,754.40 / $19,498.45
| Facility | | $1,584.89 | $5,754.40 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $11,220.18
| Facility | | $2,041.74 | $5,248.07 | $11,220.18 |