- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $4,466.84 / $10,964.78
| Facility | | $870.96 | $4,466.84 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,162.28 / $9,332.54 / $13,182.57
| Facility | 50 | $3,162.28 | $9,332.54 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,365.16 / $10,471.29
| Facility | | $1,698.24 | $4,365.16 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,380.38 / $11,481.54
| Facility | | $398.11 | $1,380.38 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,168.69 / $9,549.93
| Facility | | $1,380.38 | $4,168.69 | $9,549.93 |