- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $38,904.51
| Facility | | $7,585.78 | $7,585.78 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,897.79 / $5,128.61 / $33,113.11
| Facility | 50 | $4,897.79 | $5,128.61 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $81,283.05 / $95,499.26
| Facility | | $46,773.51 | $81,283.05 | $95,499.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $2,089.30 / $3,090.30
| Facility | | $1,995.26 | $2,089.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,819.70 / $2,630.27
| Facility | | $1,000.00 | $1,819.70 | $2,630.27 |