- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,311.31 / $10,471.29
| Facility | | $870.96 | $3,311.31 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,047.13 / $3,388.44 / $14,125.38
| Facility | 50 | $1,047.13 | $3,388.44 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $6,760.83 / $20,417.38
| Facility | | $2,089.30 | $6,760.83 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,818.38 / $14,125.38
| Facility | | $1,288.25 | $2,818.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $7,413.10 / $19,054.61
| Facility | | $2,511.89 | $7,413.10 | $19,054.61 |