- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,598.31 / $3,612.48 / $16,467.00
| Facility | | $1,598.31 | $3,612.48 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,279.29 / $1,758.14 / $2,900.07
| Facility | | $1,279.29 | $1,758.14 | $2,900.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,320.50 / $2,650.17 / $3,676.98
| Facility | 50 | $2,320.50 | $2,650.17 | $3,676.98 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $309.39 / $353.36 / $490.26
| Facility | 80 | $309.39 | $353.36 | $490.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,107.00 / $8,818.00
| Facility | | $659.00 | $6,107.00 | $8,818.00 |