- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,404.39 / $4,933.00 / $12,171.49
| Facility | | $1,404.39 | $4,933.00 | $12,171.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,087.34 / $10,607.66 / $14,450.55
| Facility | | $9,087.34 | $10,607.66 | $14,450.55 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,743.49 / $6,690.83 / $9,797.85
| Facility | 50 | $5,743.49 | $6,690.83 | $9,797.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.84 / $4,933.00 / $5,757.00
| Facility | | $1,230.84 | $4,933.00 | $5,757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,069.00 / $8,847.00 / $10,652.00
| Facility | | $4,069.00 | $8,847.00 | $10,652.00 |