- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,454.71 / $6,606.93
| Facility | | $758.58 | $2,454.71 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,019.95 / $3,019.95 / $5,754.40
| Facility | 50 | $3,019.95 | $3,019.95 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $10,471.29 / $16,595.87
| Facility | | $6,760.83 | $10,471.29 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,691.53 / $8,709.64
| Facility | | $645.65 | $2,691.53 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $4,265.80 / $8,317.64
| Facility | | $1,230.27 | $4,265.80 | $8,317.64 |