- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,547.67 / $15,862.44 / $24,365.33
| Facility | | $2,547.67 | $15,862.44 | $24,365.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,750.08 / $5,750.08 / $5,766.25
| Facility | | $5,750.08 | $5,750.08 | $5,766.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $988.37 / $1,819.77 / $2,479.38
| Facility | | $988.37 | $1,819.77 | $2,479.38 |
- 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 |