- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,168.22 / $1,168.22 / $8,173.00
| Facility | | $1,168.22 | $1,168.22 | $8,173.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,821.82 / $10,188.53 / $21,650.55
| Facility | | $4,821.82 | $10,188.53 | $21,650.55 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $13,353.29 / $20,259.84 / $35,523.86
| Facility | 50 | $13,353.29 | $20,259.84 | $35,523.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,714.62 / $3,849.66 / $9,260.89
| Facility | | $2,714.62 | $3,849.66 | $9,260.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,206.79 / $3,519.52 / $7,292.04
| Facility | | $2,206.79 | $3,519.52 | $7,292.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,517.53 / $2,250.13 / $10,878.00
| Facility | | $1,517.53 | $2,250.13 | $10,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |