- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $5,248.07 / $9,332.54
| Facility | | $2,089.30 | $5,248.07 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,548.82 / $5,370.32 / $9,549.93
| Facility | 50 | $1,548.82 | $5,370.32 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,090.30
| Facility | | $630.96 | $2,041.74 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $4,466.84 / $4,466.84
| Facility | | $4,466.84 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $912.01 / $6,309.57
| Facility | | $489.78 | $912.01 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $4,570.88 / $7,244.36
| Facility | | $3,388.44 | $4,570.88 | $7,244.36 |