- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $4,365.16 / $8,511.38
| Facility | | $1,047.13 | $4,365.16 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,818.38 / $6,456.54 / $15,135.61
| Facility | 50 | $2,818.38 | $6,456.54 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $954.99 / $1,548.82
| Facility | | $691.83 | $954.99 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $9,549.93 / $14,454.40
| Facility | | $2,884.03 | $9,549.93 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $8,709.64 / $33,884.42
| Facility | | $8,709.64 | $8,709.64 | $33,884.42 |