- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $4,168.69 / $11,220.18
| Facility | | $794.33 | $4,168.69 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,778.28 / $6,309.57 / $15,135.61
| Facility | 50 | $1,778.28 | $6,309.57 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $10,232.93 / $22,387.21
| Facility | | $2,884.03 | $10,232.93 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,862.09 / $4,897.79
| Facility | | $954.99 | $1,862.09 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $7,244.36 / $16,982.44
| Facility | | $2,454.71 | $7,244.36 | $16,982.44 |