- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $2,754.23 / $9,332.54
| Facility | | $316.23 | $2,754.23 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $489.78 / $2,951.21 / $9,772.37
| Facility | 50 | $489.78 | $2,951.21 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $4,265.80 / $11,220.18
| Facility | | $1,778.28 | $4,265.80 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $588.84 / $1,778.28
| Facility | | $213.80 | $588.84 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,202.26 / $3,715.35
| Facility | | $295.12 | $1,202.26 | $3,715.35 |