- 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
- $446.68 / $549.54 / $5,248.07
| Facility | | $446.68 | $549.54 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $676.08 / $794.33 / $7,943.28
| Facility | 50 | $676.08 | $794.33 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $1,047.13 / $4,466.84
| Facility | | $239.88 | $1,047.13 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $4,570.88 / $6,456.54
| Facility | | $3,467.37 | $4,570.88 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,248.07 / $7,413.10 / $9,772.37
| Facility | 50 | $5,248.07 | $7,413.10 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,168.69 / $4,466.84
| Facility | | $2,630.27 | $4,168.69 | $4,466.84 |