- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.82 / $6,522.04 / $10,997.06
| Facility | | $582.82 | $6,522.04 | $10,997.06 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,837.10 / $9,837.10 / $9,837.10
| Facility | 50 | $9,837.10 | $9,837.10 | $9,837.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.13 / $658.96 / $717.94
| Facility | | $549.13 | $658.96 | $717.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.84 / $636.84 / $636.84
| Facility | | $636.84 | $636.84 | $636.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,455.45 / $18,042.23 / $29,895.73
| Facility | | $13,455.45 | $18,042.23 | $29,895.73 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,549.05 / $13,142.37 / $25,726.63
| Facility | 50 | $7,549.05 | $13,142.37 | $25,726.63 |