- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,614.20 / $3,194.00 / $11,674.00
| Facility | | $1,614.20 | $3,194.00 | $11,674.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,653.06 / $4,362.71 / $15,463.42
| Facility | 50 | $1,653.06 | $4,362.71 | $15,463.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.06 / $4,689.17 / $9,300.73
| Facility | | $1,737.06 | $4,689.17 | $9,300.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $580.00 / $1,677.54
| Facility | | $580.00 | $580.00 | $1,677.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.75 / $663.40 / $1,004.00
| Facility | | $468.75 | $663.40 | $1,004.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $739.50 / $963.52 / $1,506.00
| Facility | 50 | $739.50 | $963.52 | $1,506.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $10,257.00 / $16,249.00
| Facility | | $1,258.00 | $10,257.00 | $16,249.00 |