- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $5,370.32 / $12,882.50
| Facility | | $1,096.48 | $5,370.32 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,884.03 / $7,079.46 / $16,595.87
| Facility | 50 | $2,884.03 | $7,079.46 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $10,715.19 / $21,877.62
| Facility | | $3,548.13 | $10,715.19 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,754.23 / $11,220.18
| Facility | | $1,380.38 | $2,754.23 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $7,244.36 / $16,982.44
| Facility | | $2,511.89 | $7,244.36 | $16,982.44 |