- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,128.61 / $5,495.41
| Facility | | $3,388.44 | $5,128.61 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,715.35 / $6,025.60
| Facility | | $1,737.80 | $3,715.35 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,454.71 / $5,370.32 / $9,120.11
| Facility | 50 | $2,454.71 | $5,370.32 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $1,202.26 / $5,128.61
| Facility | | $389.05 | $1,202.26 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,248.07 / $7,413.10
| Facility | | $3,981.07 | $5,248.07 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,025.60 / $8,317.64 / $10,964.78
| Facility | 50 | $6,025.60 | $8,317.64 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,495.41 / $12,302.69
| Facility | | $1,148.15 | $5,495.41 | $12,302.69 |