- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,862.09 / $4,570.88
| Facility | | $602.56 | $1,862.09 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $933.25 / $2,454.71 / $20,417.38
| Facility | 50 | $933.25 | $2,454.71 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $6,025.60 / $12,022.64
| Facility | | $3,311.31 | $6,025.60 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $6,025.60 / $6,025.60
| Facility | | $39.81 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,548.13 / $10,715.19
| Facility | | $1,023.29 | $3,548.13 | $10,715.19 |