- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,677.35 / $8,317.64
| Facility | | $2,041.74 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,019.95 / $5,370.32 / $10,715.19
| Facility | 50 | $3,019.95 | $5,370.32 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,511.89 / $3,801.89
| Facility | | $776.25 | $2,511.89 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,047.13 / $6,918.31
| Facility | | $691.83 | $1,047.13 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,623.41 / $5,623.41 / $5,623.41
| Facility | 50 | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $4,073.80 / $7,244.36
| Facility | | $3,235.94 | $4,073.80 | $7,244.36 |