- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $4,897.79 / $5,495.41
| Facility | | $3,388.44 | $4,897.79 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,187.76 / $4,168.69
| Facility | | $954.99 | $2,187.76 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,445.44 / $3,235.94 / $5,011.87
| Facility | 50 | $1,445.44 | $3,235.94 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $616.60 / $4,897.79
| Facility | | $158.49 | $616.60 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $1,819.70 / $9,332.54
| Facility | | $181.97 | $1,819.70 | $9,332.54 |