- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,467.37 / $5,623.41
| Facility | | $724.44 | $3,467.37 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,606.93 / $6,606.93 / $6,606.93
| Facility | 50 | $6,606.93 | $6,606.93 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $14,125.38 / $19,498.45
| Facility | | $2,187.76 | $14,125.38 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $645.65 / $724.44
| Facility | | $616.60 | $645.65 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $977.24 / $1,288.25
| Facility | | $630.96 | $977.24 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,762.47 / $10,964.78
| Facility | | $3,235.94 | $7,762.47 | $10,964.78 |