- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,388.44 / $5,495.41
| Facility | | $1,288.25 | $3,388.44 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $17,782.79
| Facility | 50 | $6,760.83 | $6,760.83 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,370.32 / $11,220.18
| Facility | | $2,344.23 | $5,370.32 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,548.13 / $7,762.47 / $16,982.44
| Facility | 50 | $3,548.13 | $7,762.47 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,288.25 / $4,466.84
| Facility | | $724.44 | $1,288.25 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,760.83 / $8,709.64 / $17,782.79
| Facility | 50 | $6,760.83 | $8,709.64 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $8,511.38 / $12,022.64
| Facility | | $6,918.31 | $8,511.38 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,232.93 / $13,182.57 / $18,197.01
| Facility | 50 | $10,232.93 | $13,182.57 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |