- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,201.24 / $1,838.33 / $3,188.94
| Facility | | $1,201.24 | $1,838.33 | $3,188.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $541.50 / $9,612.60 / $10,277.52
| Facility | 50 | $541.50 | $9,612.60 | $10,277.52 |
- 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
- $1,562.13 / $1,562.13 / $1,562.13
| Facility | | $1,562.13 | $1,562.13 | $1,562.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,238.18 / $4,238.18 / $4,238.18
| Facility | | $4,238.18 | $4,238.18 | $4,238.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,565.00 / $2,828.00 / $6,992.00
| Facility | | $1,565.00 | $2,828.00 | $6,992.00 |