- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.02 / $4,933.00 / $5,511.23
| Facility | | $768.02 | $4,933.00 | $5,511.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,615.28 / $3,052.82 / $4,158.77
| Facility | | $2,615.28 | $3,052.82 | $4,158.77 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,411.19 / $2,079.39 / $2,819.76
| Facility | 50 | $1,411.19 | $2,079.39 | $2,819.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $692.25 / $1,004.92 / $5,511.23
| Facility | | $692.25 | $1,004.92 | $5,511.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,388.00 / $5,202.00 / $7,373.90
| Facility | | $2,388.00 | $5,202.00 | $7,373.90 |