- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,495.41 / $7,413.10
| Facility | | $1,621.81 | $5,495.41 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $7,079.46 / $57,543.99
| Facility | | $2,570.40 | $7,079.46 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,311.31 / $10,000.00 / $85,113.80
| Facility | 50 | $3,311.31 | $10,000.00 | $85,113.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,174.90 / $5,495.41
| Facility | | $562.34 | $1,174.90 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,810.72 / $48,977.88 / $74,131.02
| Facility | | $39,810.72 | $48,977.88 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $58,884.37 / $85,113.80 / $112,201.85
| Facility | 50 | $58,884.37 | $85,113.80 | $112,201.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $151,356.12 / $165,958.69
| Facility | | $13,803.84 | $151,356.12 | $165,958.69 |