- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.05 / $1,425.83 / $7,838.38
| Facility | | $1,055.05 | $1,425.83 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,499.40 / $10,767.00 / $10,767.00
| Facility | 50 | $10,499.40 | $10,767.00 | $10,767.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,246.55 / $14,177.52 / $22,731.47
| Facility | | $4,246.55 | $14,177.52 | $22,731.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,129.95 / $1,438.11 / $1,650.73
| Facility | | $1,129.95 | $1,438.11 | $1,650.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,315.00 / $11,259.00 / $12,494.00
| Facility | | $7,315.00 | $11,259.00 | $12,494.00 |