- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,090.30 / $5,128.61
| Facility | | $1,071.52 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | 50 | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $6,309.57 / $45,708.82
| Facility | | $562.34 | $6,309.57 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $575.44 / $7,079.46
| Facility | | $204.17 | $575.44 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $3,388.44 / $3,388.44
| Facility | | $3,388.44 | $3,388.44 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $6,456.54 / $45,708.82
| Facility | | $562.34 | $6,456.54 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $12,882.50
| Facility | | $2,041.74 | $5,248.07 | $12,882.50 |