- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,495.41 / $9,332.54
| Facility | | $1,778.28 | $5,495.41 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,570.88 / $9,772.37
| Facility | | $1,995.26 | $4,570.88 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,754.23 / $6,606.93 / $14,454.40
| Facility | 50 | $2,754.23 | $6,606.93 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,380.38 / $5,495.41
| Facility | | $707.95 | $1,380.38 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,511.38 / $11,748.98
| Facility | | $6,025.60 | $8,511.38 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,912.51 / $12,882.50 / $17,782.79
| Facility | 50 | $8,912.51 | $12,882.50 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |