- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,630.78 / $7,585.78
| Facility | | $1,778.28 | $3,630.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $8,912.51
| Facility | 50 | $2,884.03 | $4,466.84 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,090.30
| Facility | | $630.96 | $2,041.74 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $831.76 / $8,128.31
| Facility | | $524.81 | $831.76 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,025.60 / $8,709.64
| Facility | | $4,466.84 | $6,025.60 | $8,709.64 |