- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $3,630.78 / $6,456.54
| Facility | | $1,318.26 | $3,630.78 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,630.27 / $7,762.47 / $13,803.84
| Facility | 50 | $2,630.27 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,265.80 / $13,803.84
| Facility | | $56.23 | $4,265.80 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $891.25 / $7,079.46
| Facility | | $416.87 | $891.25 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $616.60 / $3,235.94
| Facility | | $524.81 | $616.60 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,265.80 / $13,803.84
| Facility | | $56.23 | $4,265.80 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $12,882.50
| Facility | | $2,041.74 | $5,248.07 | $12,882.50 |