- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $10,471.29 / $17,782.79
| Facility | | $281.84 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $16,218.10 / $16,218.10 / $16,218.10
| Facility | 50 | $16,218.10 | $16,218.10 | $16,218.10 |
- 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
- $602.56 / $691.83 / $1,122.02
| Facility | | $602.56 | $691.83 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $3,981.07 / $7,413.10
| Facility | | $281.84 | $3,981.07 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $7,079.46 / $13,803.84
| Facility | | $269.15 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $501.19 / $851.14
| Professional | | $257.04 | $501.19 | $851.14 |
- 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 |