- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $20,928.72
| Facility | | $5,463.36 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,567.14 / $10,567.14 / $10,567.14
| Facility | 50 | $10,567.14 | $10,567.14 | $10,567.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,503.12 / $7,458.15 / $14,000.85
| Facility | | $5,503.12 | $7,458.15 | $14,000.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.24 / $1,073.65 / $7,772.00
| Facility | | $602.24 | $1,073.65 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,133.36 / $1,508.78 / $3,054.91
| Facility | | $1,133.36 | $1,508.78 | $3,054.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,356.00 / $7,772.00
| Facility | | $3,711.00 | $5,356.00 | $7,772.00 |