- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $931.24 / $2,698.43 / $13,150.82
| Facility | | $931.24 | $2,698.43 | $13,150.82 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,614.92 / $3,881.20 / $3,881.20
| Facility | 50 | $2,614.92 | $3,881.20 | $3,881.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,557.18 / $6,557.18 / $6,557.18
| Facility | | $6,557.18 | $6,557.18 | $6,557.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,500.89 / $5,500.89 / $12,979.93
| Facility | | $5,500.89 | $5,500.89 | $12,979.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $4,797.00 / $10,455.00
| Facility | | $1,185.00 | $4,797.00 | $10,455.00 |