- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,042.03 / $19,276.96
| Facility | | $4,083.97 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,191.00 / $9,456.18 / $13,651.50
| Facility | 50 | $2,191.00 | $9,456.18 | $13,651.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,187.86 / $8,138.72 / $15,742.91
| Facility | | $6,187.86 | $8,138.72 | $15,742.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.73 / $1,268.71 / $13,800.21
| Facility | | $645.73 | $1,268.71 | $13,800.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $13,622.63 / $13,622.63 / $13,622.63
| Facility | 50 | $13,622.63 | $13,622.63 | $13,622.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,032.88 / $1,385.76 / $7,021.68
| Facility | | $1,032.88 | $1,385.76 | $7,021.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |