- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $4,466.84 / $5,495.41
| Facility | | $4,365.16 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,128.61 / $11,748.98
| Facility | | $3,235.94 | $5,128.61 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,786.30 / $7,762.47 / $16,595.87
| Facility | 50 | $4,786.30 | $7,762.47 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,995.26 / $3,235.94
| Facility | | $1,202.26 | $1,995.26 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $9,332.54 / $12,589.25
| Facility | | $7,585.78 | $9,332.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,220.18 / $14,125.38 / $18,197.01
| Facility | 50 | $11,220.18 | $14,125.38 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $10,232.93 / $27,542.29
| Facility | | $2,089.30 | $10,232.93 | $27,542.29 |