- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $4,168.69 / $10,715.19
| Facility | | $549.54 | $4,168.69 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,698.24 / $4,897.79 / $10,715.19
| Facility | 50 | $1,698.24 | $4,897.79 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,202.26 / $1,412.54
| Facility | | $323.59 | $1,202.26 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $8,317.64 / $16,595.87
| Facility | | $4,365.16 | $8,317.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $5,623.41 / $9,772.37
| Facility | | $1,905.46 | $5,623.41 | $9,772.37 |