- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.25 / $2,477.00 / $7,791.19
| Facility | | $543.25 | $2,477.00 | $7,791.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,495.91 / $2,973.08 / $8,055.00
| Facility | 50 | $2,495.91 | $2,973.08 | $8,055.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,263.00 / $4,589.00 / $10,517.23
| Facility | | $3,263.00 | $4,589.00 | $10,517.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $752.36 / $1,037.78 / $1,389.06
| Facility | | $752.36 | $1,037.78 | $1,389.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.50 / $4,044.50 / $8,138.00
| Facility | | $1,967.50 | $4,044.50 | $8,138.00 |