- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,095.32 / $5,645.69 / $19,020.74
| Facility | | $1,095.32 | $5,645.69 | $19,020.74 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,634.87 / $4,921.41 / $13,539.91
| Facility | 50 | $3,634.87 | $4,921.41 | $13,539.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.00 / $12,289.00 / $37,919.46
| Facility | | $3,350.00 | $12,289.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,050.14 / $1,417.69 / $2,205.30
| Facility | | $1,050.14 | $1,417.69 | $2,205.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,126.14 / $7,126.14 / $7,126.14
| Facility | | $7,126.14 | $7,126.14 | $7,126.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,296.00 / $17,380.00
| Facility | | $5,431.00 | $12,296.00 | $17,380.00 |