- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,113.61 / $7,023.00 / $12,024.10
| Facility | | $1,113.61 | $7,023.00 | $12,024.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,571.90 / $15,788.64 / $26,176.75
| Facility | 50 | $11,571.90 | $15,788.64 | $26,176.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,465.85 / $6,988.35 / $13,239.43
| Facility | | $2,465.85 | $6,988.35 | $13,239.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $1,956.98 / $2,514.75
| Facility | | $715.00 | $1,956.98 | $2,514.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.46 / $937.24 / $1,720.36
| Facility | | $670.46 | $937.24 | $1,720.36 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,086.00 / $1,436.25 / $2,629.13
| Facility | 50 | $1,086.00 | $1,436.25 | $2,629.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |