- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,778.28 / $4,073.80
| Facility | | $575.44 | $1,778.28 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,454.71 / $15,488.17 / $18,620.87
| Facility | 50 | $2,454.71 | $15,488.17 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $4,073.80 / $5,888.44
| Facility | | $1,621.81 | $4,073.80 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,041.74 / $2,041.74
| Facility | | $2,041.74 | $2,041.74 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $8,709.64 / $19,498.45
| Facility | | $8,709.64 | $8,709.64 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $4,570.88 / $7,585.78
| Facility | | $2,754.23 | $4,570.88 | $7,585.78 |