- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $9,185.68 / $20,928.72
| Facility | | $4,241.22 | $9,185.68 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,439.30 / $6,054.31 / $10,506.50
| Facility | 50 | $3,439.30 | $6,054.31 | $10,506.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,187.86 / $8,386.12 / $15,742.91
| Facility | | $6,187.86 | $8,386.12 | $15,742.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.51 / $1,235.25 / $8,632.00
| Facility | | $710.51 | $1,235.25 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,482.53 / $4,482.53 / $4,482.53
| Facility | 50 | $4,482.53 | $4,482.53 | $4,482.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.52 / $1,787.17 / $2,865.45
| Facility | | $1,304.52 | $1,787.17 | $2,865.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |