- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $9,332.54 / $13,489.63
| Facility | | $758.58 | $9,332.54 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,187.76 / $7,585.78 / $21,877.62
| Facility | 50 | $2,187.76 | $7,585.78 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,882.50 / $21,877.62
| Facility | | $7,585.78 | $12,882.50 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,122.02 / $1,778.28
| Facility | | $954.99 | $1,122.02 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $3,981.07 / $7,413.10
| Facility | | $446.68 | $3,981.07 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $6,918.31 / $13,803.84
| Facility | | $436.52 | $6,918.31 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.65 / $1,479.11 / $2,951.21
| Facility | 50 | $0.65 | $1,479.11 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $812.83 / $1,380.38
| Professional | | $416.87 | $812.83 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $13,803.84 / $13,803.84
| Facility | | $9,332.54 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |