- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $5,495.41 / $8,912.51
| Facility | | $549.54 | $5,495.41 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,548.13 / $9,120.11
| Facility | | $1,819.70 | $3,548.13 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,691.53 / $5,128.61 / $13,489.63
| Facility | 50 | $2,691.53 | $5,128.61 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,445.44 / $6,606.93
| Facility | | $295.12 | $1,445.44 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $7,762.47 / $11,220.18
| Facility | | $6,025.60 | $7,762.47 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,912.51 / $12,882.50 / $16,595.87
| Facility | 50 | $8,912.51 | $12,882.50 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |