- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,570.88 / $9,120.11
| Facility | | $1,071.52 | $4,570.88 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,511.89 / $6,456.54 / $9,120.11
| Facility | 50 | $2,511.89 | $6,456.54 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $8,912.51
| Facility | | $2,238.72 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $5,495.41 / $7,244.36
| Facility | | $588.84 | $5,495.41 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,398.83 / $26,302.68
| Facility | | $501.19 | $2,398.83 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,398.83 / $4,677.35
| Facility | | $1,737.80 | $2,398.83 | $4,677.35 |