- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,458.68 / $10,492.00 / $16,964.71
| Facility | | $4,458.68 | $10,492.00 | $16,964.71 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,155.02 / $12,682.00 / $22,500.00
| Facility | 50 | $5,155.02 | $12,682.00 | $22,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,192.00 / $17,206.00 / $25,477.00
| Facility | | $10,192.00 | $17,206.00 | $25,477.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,212.00 / $9,619.46 / $15,639.00
| Facility | | $2,212.00 | $9,619.46 | $15,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,056.56 / $11,057.00 / $11,283.00
| Facility | | $10,056.56 | $11,057.00 | $11,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,231.37 / $10,191.54 / $16,203.27
| Facility | | $8,231.37 | $10,191.54 | $16,203.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,943.00 / $10,797.00 / $17,772.00
| Facility | | $6,943.00 | $10,797.00 | $17,772.00 |