- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,273.50 / $2,663.12 / $4,806.64
| Facility | | $1,273.50 | $2,663.12 | $4,806.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $821.00 / $2,904.60 / $9,296.98
| Facility | 50 | $821.00 | $2,904.60 | $9,296.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,707.18 / $5,097.00 / $16,394.00
| Facility | | $1,707.18 | $5,097.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.95 / $1,642.76 / $6,679.00
| Facility | | $759.95 | $1,642.76 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.19 / $2,203.15 / $2,809.98
| Facility | | $1,403.19 | $2,203.15 | $2,809.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $6,280.00 / $16,394.00
| Facility | | $2,324.00 | $6,280.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $5,097.00 / $10,764.00
| Facility | | $2,324.00 | $5,097.00 | $10,764.00 |