- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $3,890.45 / $10,964.78
| Facility | | $416.87 | $3,890.45 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $501.19 / $2,398.83 / $7,413.10
| Facility | 50 | $501.19 | $2,398.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $6,760.83 / $18,197.01
| Facility | | $2,238.72 | $6,760.83 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $691.83 / $5,754.40
| Facility | | $338.84 | $691.83 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,754.40 / $14,125.38
| Facility | | $1,995.26 | $5,754.40 | $14,125.38 |