- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,505.75 / $7,505.81 / $27,887.69
| Facility | | $1,505.75 | $7,505.81 | $27,887.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,713.72 / $5,713.72 / $5,729.78
| Facility | | $5,713.72 | $5,713.72 | $5,729.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $690.88 / $1,366.48 / $1,806.90
| Facility | | $690.88 | $1,366.48 | $1,806.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,896.50 / $17,361.59 / $22,059.79
| Facility | | $12,896.50 | $17,361.59 | $22,059.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $18,231.00 / $26,042.39 / $33,802.19
| Facility | 50 | $18,231.00 | $26,042.39 | $33,802.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $11,800.00 / $29,092.00
| Facility | | $2,600.00 | $11,800.00 | $29,092.00 |