- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $10,964.78 / $23,442.29
| Facility | | $4,466.84 | $10,964.78 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,918.31 / $6,918.31 / $6,918.31
| Facility | 50 | $6,918.31 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $20,417.38 / $21,379.62
| Facility | | $8,317.64 | $20,417.38 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $35,481.34 / $61,659.50
| Facility | | $16,595.87 | $35,481.34 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $12,302.69 / $29,512.09
| Facility | | $5,128.61 | $12,302.69 | $29,512.09 |