- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,565.61 / $7,943.37 / $20,928.72
| Facility | | $3,565.61 | $7,943.37 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,813.94 / $8,056.00 / $11,400.00
| Facility | 50 | $7,813.94 | $8,056.00 | $11,400.00 |
- 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
- $804.80 / $1,499.68 / $10,864.34
| Facility | | $804.80 | $1,499.68 | $10,864.34 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,425.09 / $5,425.09 / $5,425.09
| Facility | 50 | $5,425.09 | $5,425.09 | $5,425.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $1,839.49 / $4,968.71
| Facility | | $1,392.00 | $1,839.49 | $4,968.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |