- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $8,709.64 / $16,595.87
| Facility | | $501.19 | $8,709.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,265.80 / $14,791.08 / $14,791.08
| Facility | 50 | $4,265.80 | $14,791.08 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Professional | 50 | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $251.19 / $281.84 / $512.86
| Professional | 50 | $251.19 | $281.84 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,890.45 / $7,079.46
| Facility | | $1,584.89 | $3,890.45 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $1,778.28
| Facility | | $575.44 | $575.44 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $512.86 / $891.25
| Facility | | $354.81 | $512.86 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $16,982.44
| Facility | | $2,754.23 | $11,220.18 | $16,982.44 |