- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,327.44 / $10,500.00 / $18,123.41
| Facility | | $1,327.44 | $10,500.00 | $18,123.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,543.00 / $9,339.07 / $16,615.37
| Facility | | $3,543.00 | $9,339.07 | $16,615.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.96 / $3,711.96 / $4,769.93
| Facility | | $3,711.96 | $3,711.96 | $4,769.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,128.32 / $1,401.92 / $2,293.83
| Facility | | $1,128.32 | $1,401.92 | $2,293.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,102.88 / $2,102.88 / $2,939.32
| Facility | 50 | $2,102.88 | $2,102.88 | $2,939.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |