- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,495.41 / $12,302.69
| Facility | | $1,023.29 | $5,495.41 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,318.26 / $12,589.25 / $12,589.25
| Facility | 50 | $1,318.26 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,090.30 / $4,897.79
| Facility | | $2,290.87 | $3,090.30 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,819.70 / $26,302.68
| Facility | | $741.31 | $1,819.70 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | 50 | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,951.21 / $6,309.57
| Facility | | $1,862.09 | $2,951.21 | $6,309.57 |