- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $988.20 / $7,838.38 / $8,763.29
| Facility | | $988.20 | $7,838.38 | $8,763.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,841.07 / $11,686.50 / $12,037.50
| Facility | 50 | $2,841.07 | $11,686.50 | $12,037.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,887.35 / $19,655.50 / $31,514.59
| Facility | | $5,887.35 | $19,655.50 | $31,514.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $844.59 / $1,074.93 / $1,298.95
| Facility | | $844.59 | $1,074.93 | $1,298.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,028.00 / $15,131.00 / $16,269.00
| Facility | | $9,028.00 | $15,131.00 | $16,269.00 |