- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $4,897.79 / $25,118.86
| Facility | | $812.83 | $4,897.79 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $891.25 / $6,309.57 / $8,317.64
| Facility | 50 | $891.25 | $6,309.57 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $630.96 / $1,023.29
| Facility | | $173.78 | $630.96 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,089.30 / $6,918.31
| Facility | | $794.33 | $2,089.30 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $891.25 / $6,309.57 / $8,317.64
| Facility | 50 | $891.25 | $6,309.57 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $6,456.54 / $10,471.29
| Facility | | $3,019.95 | $6,456.54 | $10,471.29 |