- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $4,073.80 / $14,125.38
| Facility | | $812.83 | $4,073.80 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,949.84 / $4,897.79 / $23,988.33
| Facility | 50 | $1,949.84 | $4,897.79 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $12,589.25 / $53,703.18
| Facility | | $2,630.27 | $12,589.25 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $10,232.93 / $16,982.44
| Facility | | $3,311.31 | $10,232.93 | $16,982.44 |