- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $888.89 / $3,925.08 / $9,329.29
| Facility | | $888.89 | $3,925.08 | $9,329.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,801.03 / $6,252.17 / $10,977.61
| Facility | 50 | $3,801.03 | $6,252.17 | $10,977.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,302.10 / $6,548.00 / $14,996.00
| Facility | | $3,302.10 | $6,548.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.63 / $2,103.13 / $3,140.55
| Facility | | $1,775.63 | $2,103.13 | $3,140.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $5,735.00 / $9,622.00
| Facility | | $2,637.00 | $5,735.00 | $9,622.00 |