- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,186.29 / $5,355.07 / $8,146.23
| Facility | | $1,186.29 | $5,355.07 | $8,146.23 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,829.78 / $7,514.00 / $15,051.00
| Facility | 50 | $2,829.78 | $7,514.00 | $15,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.26 / $957.50 / $1,752.75
| Facility | | $694.26 | $957.50 | $1,752.75 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,054.50 / $1,436.25 / $2,754.23
| Facility | 50 | $1,054.50 | $1,436.25 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.00 / $9,541.00 / $14,589.00
| Facility | | $3,366.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,995.52 / $8,723.79 / $26,542.00
| Facility | | $3,995.52 | $8,723.79 | $26,542.00 |