- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,513.56 / $5,623.41
| Facility | | $446.68 | $1,513.56 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $234.42 / $1,348.96 / $2,238.72
| Facility | 50 | $234.42 | $1,348.96 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,995.26 / $2,951.21
| Facility | | $616.60 | $1,995.26 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $323.59 / $2,041.74
| Facility | | $194.98 | $323.59 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,412.54 / $2,187.76
| Facility | | $691.83 | $1,412.54 | $2,187.76 |