- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $2,511.89 / $6,760.83
| Facility | | $380.19 | $2,511.89 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,165.95 / $6,165.95 / $6,165.95
| Facility | 50 | $6,165.95 | $6,165.95 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,964.78 / $18,197.01
| Facility | | $7,079.46 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $3,019.95 / $10,715.19
| Facility | | $263.03 | $3,019.95 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $4,677.35 / $8,511.38
| Facility | | $1,230.27 | $4,677.35 | $8,511.38 |