- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,818.38 / $8,912.51
| Facility | | $537.03 | $2,818.38 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,258.93 / $2,137.96 / $7,585.78
| Facility | 50 | $1,258.93 | $2,137.96 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,786.30 / $12,589.25
| Facility | | $2,570.40 | $4,786.30 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $1,949.84 / $5,888.44
| Facility | | $162.18 | $1,949.84 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,202.26 / $3,630.78
| Facility | | $295.12 | $1,202.26 | $3,630.78 |