- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,677.35 / $13,182.57
| Facility | | $645.65 | $4,677.35 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,513.56 / $3,467.37 / $15,488.17
| Facility | 50 | $1,513.56 | $3,467.37 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $13,182.57 / $53,703.18
| Facility | | $2,398.83 | $13,182.57 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $776.25 / $776.25 / $776.25
| Facility | 22 | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $7,762.47 / $12,022.64
| Facility | | $2,630.27 | $7,762.47 | $12,022.64 |