- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $8,912.51 / $15,848.93
| Facility | | $2,884.03 | $8,912.51 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,162.28 / $10,232.93 / $17,378.01
| Facility | 50 | $3,162.28 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $10,715.19 / $23,988.33
| Facility | | $2,884.03 | $10,715.19 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $6,760.83
| Facility | | $812.83 | $812.83 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,778.28 / $3,311.31
| Facility | | $1,174.90 | $1,778.28 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $19,952.62 / $25,703.96
| Facility | | $8,709.64 | $19,952.62 | $25,703.96 |