- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $4,897.79 / $14,125.38
| Facility | | $707.95 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $7,762.47
| Facility | 50 | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $14,125.38 / $19,498.45
| Facility | | $4,365.16 | $14,125.38 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $707.95 / $812.83
| Facility | | $691.83 | $707.95 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,122.02 / $1,584.89
| Facility | | $758.58 | $1,122.02 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,762.47 / $10,964.78
| Facility | | $3,235.94 | $7,762.47 | $10,964.78 |