- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $4,466.84 / $13,803.84
| Facility | | $1,548.82 | $4,466.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,388.44 / $4,168.69 / $14,125.38
| Facility | 50 | $3,388.44 | $4,168.69 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,897.79 / $16,218.10
| Facility | | $2,238.72 | $4,897.79 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $13,803.84 / $15,848.93
| Facility | | $7,413.10 | $13,803.84 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,290.87 / $26,302.68
| Facility | | $630.96 | $2,290.87 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,019.95 / $5,754.40
| Facility | | $2,137.96 | $3,019.95 | $5,754.40 |