- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $1,584.89
| Facility | | $724.44 | $724.44 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | 50 | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $977.24
| Facility | | $794.33 | $794.33 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,288.25 / $1,659.59
| Facility | | $1,288.25 | $1,288.25 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $28,840.32
| Facility | | $25,118.86 | $25,118.86 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $45,708.82
| Facility | 50 | $10,964.78 | $10,964.78 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $22,908.68
| Facility | | $3,548.13 | $3,548.13 | $22,908.68 |