- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,376.17 / $1,376.17 / $1,376.17
| Facility | | $1,376.17 | $1,376.17 | $1,376.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,049.99 / $23,225.56 / $48,409.91
| Facility | | $7,049.99 | $23,225.56 | $48,409.91 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $31,061.07 / $47,126.44 / $82,632.05
| Facility | 50 | $31,061.07 | $47,126.44 | $82,632.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,402.75 / $4,825.52 / $11,608.44
| Facility | | $3,402.75 | $4,825.52 | $11,608.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,766.19 / $4,411.68 / $9,140.50
| Facility | | $2,766.19 | $4,411.68 | $9,140.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,782.76 / $2,452.36 / $3,557.38
| Facility | | $1,782.76 | $2,452.36 | $3,557.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |