- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $6,165.95 / $15,488.17
| Facility | | $1,023.29 | $6,165.95 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,890.45 / $9,772.37 / $19,952.62
| Facility | 50 | $3,890.45 | $9,772.37 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $11,220.18 / $26,302.68
| Facility | | $4,073.80 | $11,220.18 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,981.07 / $14,125.38
| Facility | | $1,047.13 | $3,981.07 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $8,912.51 / $20,892.96
| Facility | | $3,019.95 | $8,912.51 | $20,892.96 |