- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,061.01 / $2,061.01 / $2,061.01
| Facility | | $2,061.01 | $2,061.01 | $2,061.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $18,990.28 / $18,990.28 / $18,990.28
| Facility | 50 | $18,990.28 | $18,990.28 | $18,990.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,720.86 / $23,699.55 / $50,361.37
| Facility | | $10,720.86 | $23,699.55 | $50,361.37 |
- 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
- $5,081.38 / $7,206.03 / $17,335.07
| Facility | | $5,081.38 | $7,206.03 | $17,335.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,130.80 / $6,588.04 / $13,649.66
| Facility | | $4,130.80 | $6,588.04 | $13,649.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,719.99 / $3,634.77 / $5,163.75
| Facility | | $2,719.99 | $3,634.77 | $5,163.75 |
- 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 |