- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $6,760.83 / $16,595.87
| Facility | | $2,818.38 | $6,760.83 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,659.59 / $4,570.88 / $8,317.64
| Facility | 50 | $1,659.59 | $4,570.88 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,365.16 / $9,549.93
| Facility | | $1,698.24 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $676.08 / $1,230.27
| Facility | | $457.09 | $676.08 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,964.78 / $16,982.44
| Facility | | $1,995.26 | $10,964.78 | $16,982.44 |