- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.74 / $1,015.74 / $1,015.74
| Facility | | $1,015.74 | $1,015.74 | $1,015.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,748.94 / $11,203.41 / $22,223.37
| Facility | | $6,748.94 | $11,203.41 | $22,223.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $12,530.52 / $19,011.54 / $33,335.05
| Facility | 50 | $12,530.52 | $19,011.54 | $33,335.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $3,187.95 / $7,669.04
| Facility | | $2,248.00 | $3,187.95 | $7,669.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,827.46 / $2,914.55 / $6,038.61
| Facility | | $1,827.46 | $2,914.55 | $6,038.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.61 / $1,860.57 / $12,367.00
| Facility | | $882.61 | $1,860.57 | $12,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |