- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $7,762.47 / $14,791.08
| Facility | | $2,290.87 | $7,762.47 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $2,238.72
| Facility | 50 | $2,238.72 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $5,495.41 / $10,232.93
| Facility | | $2,630.27 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $2,570.40
| Facility | | $707.95 | $707.95 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $851.14 / $1,584.89
| Facility | | $645.65 | $851.14 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $13,182.57 / $23,988.33
| Facility | | $2,137.96 | $13,182.57 | $23,988.33 |