- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.78 / $2,193.32 / $7,838.38
| Facility | | $667.78 | $2,193.32 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,900.76 / $6,786.86 / $8,992.44
| Facility | 50 | $2,900.76 | $6,786.86 | $8,992.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $4,589.00 / $11,136.00
| Facility | | $3,283.00 | $4,589.00 | $11,136.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.57 / $2,197.01 / $3,463.76
| Facility | | $1,643.57 | $2,197.01 | $3,463.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $5,735.00 / $9,622.00
| Facility | | $2,637.00 | $5,735.00 | $9,622.00 |