- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,212.55 / $4,933.00 / $5,757.00
| Facility | | $3,212.55 | $4,933.00 | $5,757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,018.27 / $15,173.25 / $20,557.34
| Facility | | $13,018.27 | $15,173.25 | $20,557.34 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,719.64 / $10,278.67 / $13,405.18
| Facility | 50 | $8,719.64 | $10,278.67 | $13,405.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,921.50 / $4,933.00 / $5,757.00
| Facility | | $2,921.50 | $4,933.00 | $5,757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,080.11 / $7,519.00 / $10,351.00
| Facility | | $2,080.11 | $7,519.00 | $10,351.00 |