- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,400.00 / $1,557.88 / $1,557.88
| Facility | | $1,400.00 | $1,557.88 | $1,557.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,087.47 / $5,087.47 / $5,087.47
| Facility | 50 | $5,087.47 | $5,087.47 | $5,087.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.50 / $589.79 / $642.59
| Facility | | $528.50 | $589.79 | $642.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.37 / $567.37 / $567.37
| Facility | | $567.37 | $567.37 | $567.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,929.80 / $54,271.47 / $74,060.32
| Facility | | $24,929.80 | $54,271.47 | $74,060.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $12,254.85 / $20,429.16 / $39,491.07
| Facility | 50 | $12,254.85 | $20,429.16 | $39,491.07 |