- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,466.84 / $5,495.41
| Facility | | $1,412.54 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,258.93 / $4,168.69
| Facility | | $562.34 | $1,258.93 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $831.76 / $1,949.84 / $6,309.57
| Facility | 50 | $831.76 | $1,949.84 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $724.44 / $3,162.28
| Facility | | $190.55 | $724.44 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $8,317.64 / $9,332.54
| Facility | | $1,819.70 | $8,317.64 | $9,332.54 |