- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $840.54 / $3,702.43 / $3,702.43
| Facility | | $840.54 | $3,702.43 | $3,702.43 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,181.11 / $9,837.10 / $9,837.10
| Facility | 50 | $3,181.11 | $9,837.10 | $9,837.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.91 / $949.03 / $1,033.99
| Facility | | $852.91 | $949.03 | $1,033.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $913.23 / $913.23 / $913.23
| Facility | | $913.23 | $913.23 | $913.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,322.34 / $8,322.34 / $27,411.26
| Facility | | $8,322.34 | $8,322.34 | $27,411.26 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,020.12 / $8,128.49 / $20,905.99
| Facility | 50 | $5,020.12 | $8,128.49 | $20,905.99 |