- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,466.84 / $11,481.54
| Facility | | $2,344.23 | $4,466.84 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,187.76 / $2,238.72 / $2,398.83
| Facility | 50 | $2,187.76 | $2,238.72 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,128.31 / $15,848.93
| Facility | | $6,165.95 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $2,089.30 / $10,964.78
| Facility | | $691.83 | $2,089.30 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $22,908.68
| Facility | 50 | $19,952.62 | $19,952.62 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,238.72 / $2,344.23
| Professional | | $1,698.24 | $2,238.72 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,413.10 / $10,964.78
| Facility | | $6,309.57 | $7,413.10 | $10,964.78 |