- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.02 / $2,897.00 / $9,319.10
| Facility | | $521.02 | $2,897.00 | $9,319.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,591.69 / $7,330.50 / $15,417.60
| Facility | 50 | $2,591.69 | $7,330.50 | $15,417.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.43 / $399.84 / $560.44
| Facility | | $212.43 | $399.84 | $560.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,206.57 / $8,585.95 / $11,346.40
| Facility | | $5,206.57 | $8,585.95 | $11,346.40 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,083.15 / $12,878.94 / $17,693.96
| Facility | 50 | $7,083.15 | $12,878.94 | $17,693.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,550.00 / $12,152.00 / $12,233.00
| Facility | | $5,550.00 | $12,152.00 | $12,233.00 |