- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,039.38 / $1,846.00 / $8,948.00
| Facility | | $1,039.38 | $1,846.00 | $8,948.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,757.11 / $4,643.10 / $13,426.00
| Facility | 50 | $1,757.11 | $4,643.10 | $13,426.00 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $4,148.00 / $4,148.00 / $4,148.00
| Facility | 80 | $4,148.00 | $4,148.00 | $4,148.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,044.39 / $6,044.39 / $7,253.27
| Facility | | $6,044.39 | $6,044.39 | $7,253.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,401.74 / $1,401.74 / $1,401.74
| Facility | | $1,401.74 | $1,401.74 | $1,401.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,447.62 / $3,447.62 / $3,447.62
| Facility | | $3,447.62 | $3,447.62 | $3,447.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.00 / $2,311.00 / $5,652.00
| Facility | | $1,240.00 | $2,311.00 | $5,652.00 |