- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,818.38 / $15,135.61
| Facility | | $575.44 | $2,818.38 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $14,125.38
| Facility | 50 | $14,125.38 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,290.87 / $16,218.10
| Facility | | $724.44 | $2,290.87 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $13,803.84 / $15,848.93
| Facility | | $7,413.10 | $13,803.84 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,187.76 / $12,022.64
| Facility | | $575.44 | $2,187.76 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,019.95 / $5,754.40
| Facility | | $2,137.96 | $3,019.95 | $5,754.40 |