- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.27 / $2,456.80 / $7,762.38
| Facility | | $293.27 | $2,456.80 | $7,762.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $642.72 / $2,118.50 / $6,916.68
| Facility | 50 | $642.72 | $2,118.50 | $6,916.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $2,390.91 / $5,749.50
| Facility | | $1,787.00 | $2,390.91 | $5,749.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.77 / $479.16 / $766.00
| Facility | | $416.77 | $479.16 | $766.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.50 / $1,189.50 / $2,699.00
| Facility | | $363.50 | $1,189.50 | $2,699.00 |