- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,995.26 / $3,311.31
| Facility | | $776.25 | $1,995.26 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,884.03 / $2,884.03 / $18,197.01
| Facility | 50 | $2,884.03 | $2,884.03 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $2,884.03 / $2,884.03
| Facility | | $2,884.03 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $7,244.36
| Facility | | $2,754.23 | $2,754.23 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $4,365.16 / $12,022.64
| Facility | | $977.24 | $4,365.16 | $12,022.64 |