- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $2,344.23 / $5,623.41
| Facility | | $977.24 | $2,344.23 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $524.81 / $2,754.23 / $6,606.93
| Facility | 50 | $524.81 | $2,754.23 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $1,318.26 / $1,995.26
| Facility | | $416.87 | $1,318.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $912.01 / $6,918.31
| Facility | | $616.60 | $912.01 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $4,073.80 / $7,244.36
| Facility | | $3,235.94 | $4,073.80 | $7,244.36 |