- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,284.80 / $7,529.30 / $12,485.19
| Facility | | $2,284.80 | $7,529.30 | $12,485.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.71 / $5,650.87 / $9,782.00
| Facility | | $2,777.71 | $5,650.87 | $9,782.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $715.00 / $2,594.85
| Facility | | $715.00 | $715.00 | $2,594.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.00 / $836.46 / $1,165.25
| Facility | | $608.00 | $836.46 | $1,165.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $912.00 / $1,254.69 / $1,747.88
| Facility | 50 | $912.00 | $1,254.69 | $1,747.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $12,456.00 / $19,591.00
| Facility | | $1,779.00 | $12,456.00 | $19,591.00 |