- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $6,165.95 / $11,481.54
| Facility | | $776.25 | $6,165.95 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,884.03 / $4,570.88 / $8,709.64
| Facility | 50 | $2,884.03 | $4,570.88 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,621.81 / $3,162.28
| Facility | | $1,230.27 | $1,621.81 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,096.48 / $11,481.54
| Facility | | $346.74 | $1,096.48 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,456.54 / $6,456.54 / $19,498.45
| Facility | 50 | $6,456.54 | $6,456.54 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $870.96 / $1,148.15
| Professional | | $831.76 | $870.96 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $15,135.61 / $17,782.79
| Facility | | $15,135.61 | $15,135.61 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,413.10 / $9,332.54
| Facility | | $4,786.30 | $7,413.10 | $9,332.54 |