- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $12,029.70 / $24,068.03
| Facility | | $5,463.36 | $12,029.70 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,395.00 / $15,878.40 / $17,707.77
| Facility | 50 | $11,395.00 | $15,878.40 | $17,707.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,187.86 / $8,386.12 / $15,742.91
| Facility | | $6,187.86 | $8,386.12 | $15,742.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.86 / $1,068.09 / $14,165.40
| Facility | | $615.86 | $1,068.09 | $14,165.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,131.04 / $1,508.74 / $6,031.36
| Facility | | $1,131.04 | $1,508.74 | $6,031.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |