- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,812.90 / $1,812.90 / $1,812.90
| Facility | | $1,812.90 | $1,812.90 | $1,812.90 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,817.40 / $1,817.40 / $6,904.77
| Facility | 50 | $1,817.40 | $1,817.40 | $6,904.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.04 / $557.11 / $606.97
| Facility | | $499.04 | $557.11 | $606.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.91 / $534.91 / $534.91
| Facility | | $534.91 | $534.91 | $534.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,041.52 / $12,041.52 / $12,749.25
| Facility | | $12,041.52 | $12,041.52 | $12,749.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,340.58 / $8,753.95 / $36,427.25
| Facility | 50 | $1,340.58 | $8,753.95 | $36,427.25 |