- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.44 / $4,033.00 / $7,119.04
| Facility | | $986.44 | $4,033.00 | $7,119.04 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,615.84 / $6,615.84 / $9,456.18
| Facility | 50 | $6,615.84 | $6,615.84 | $9,456.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.05 / $835.43 / $1,470.14
| Professional | | $517.05 | $835.43 | $1,470.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.57 / $1,512.05 / $16,022.90
| Facility | | $716.57 | $1,512.05 | $16,022.90 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,010.02 / $6,010.02 / $6,010.02
| Facility | 50 | $6,010.02 | $6,010.02 | $6,010.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $978.00 / $1,732.15 / $7,125.13
| Facility | | $978.00 | $1,732.15 | $7,125.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,221.00 / $8,523.00 / $11,869.99
| Facility | | $7,221.00 | $8,523.00 | $11,869.99 |