- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $4,897.79 / $12,302.69
| Facility | | $676.08 | $4,897.79 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,165.95 / $6,165.95 / $9,549.93
| Facility | 50 | $6,165.95 | $6,165.95 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,258.93 / $1,258.93
| Facility | | $524.81 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,041.74 / $6,918.31
| Facility | | $645.65 | $2,041.74 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,165.95 / $6,165.95 / $9,549.93
| Facility | 50 | $6,165.95 | $6,165.95 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,786.30 / $8,317.64
| Facility | | $2,238.72 | $4,786.30 | $8,317.64 |