- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.06 / $1,880.70 / $7,508.37
| Facility | | $1,248.06 | $1,880.70 | $7,508.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,092.23 / $1,092.23 / $13,626.99
| Facility | 50 | $1,092.23 | $1,092.23 | $13,626.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.19 / $714.18 / $731.79
| Professional | | $576.19 | $714.18 | $731.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $625.17 / $899.42 / $1,195.75
| Professional | | $625.17 | $899.42 | $1,195.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,131.96 / $6,131.96 / $6,131.96
| Facility | | $6,131.96 | $6,131.96 | $6,131.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $12,447.50 / $12,447.50 / $12,447.50
| Facility | 50 | $12,447.50 | $12,447.50 | $12,447.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $795.66 / $1,034.08 / $2,360.29
| Professional | | $795.66 | $1,034.08 | $2,360.29 |