- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $5,248.07 / $8,128.31
| Facility | | $645.65 | $5,248.07 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,479.11 / $2,398.83 / $15,135.61
| Facility | 50 | $1,479.11 | $2,398.83 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $1,047.13
| Facility | | $141.25 | $141.25 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $4,897.79 / $8,128.31
| Facility | | $630.96 | $4,897.79 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,479.11 / $2,398.83 / $15,135.61
| Facility | 50 | $1,479.11 | $2,398.83 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $6,918.31 / $15,135.61
| Facility | | $4,677.35 | $6,918.31 | $15,135.61 |