- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $3,981.07 / $10,964.78
| Facility | | $489.78 | $3,981.07 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $707.95 / $2,754.23 / $6,760.83
| Facility | 50 | $707.95 | $2,754.23 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $8,511.38 / $18,197.01
| Facility | | $3,019.95 | $8,511.38 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,659.59 / $17,782.79
| Facility | | $398.11 | $1,659.59 | $17,782.79 |
- 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 |