- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.67 / $550.67 / $550.67
| Facility | | $550.67 | $550.67 | $550.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,673.80 / $5,919.70 / $12,579.32
| Facility | | $2,673.80 | $5,919.70 | $12,579.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,758.47 / $11,771.30 / $20,639.93
| Facility | 50 | $7,758.47 | $11,771.30 | $20,639.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,368.68 / $1,940.96 / $4,669.22
| Facility | | $1,368.68 | $1,940.96 | $4,669.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,112.64 / $1,774.50 / $3,676.56
| Facility | | $1,112.64 | $1,774.50 | $3,676.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.30 / $1,083.04 / $8,909.04
| Facility | | $629.30 | $1,083.04 | $8,909.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |