- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,096.48 / $7,762.47
| Facility | | $776.25 | $1,096.48 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | 50 | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $15,488.17 / $25,118.86
| Facility | | $4,466.84 | $15,488.17 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $870.96 / $1,479.11
| Facility | | $575.44 | $870.96 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $9,120.11 / $16,982.44
| Facility | | $794.33 | $9,120.11 | $16,982.44 |