- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,495.41 / $19,054.61
| Facility | | $1,000.00 | $5,495.41 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,760.83 / $18,620.87
| Facility | | $2,187.76 | $6,760.83 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,235.94 / $10,000.00 / $28,183.83
| Facility | 50 | $3,235.94 | $10,000.00 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,265.80
| Facility | | $4,168.69 | $4,168.69 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,071.52 / $2,951.21
| Facility | | $616.60 | $1,071.52 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $16,218.10 / $22,908.68
| Facility | | $12,022.64 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $18,197.01 / $26,302.68 / $34,673.69
| Facility | 50 | $18,197.01 | $26,302.68 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $9,332.54 / $18,197.01
| Facility | | $1,513.56 | $9,332.54 | $18,197.01 |