- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $3,162.28 / $10,715.19
| Facility | | $489.78 | $3,162.28 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $6,760.83
| Facility | 50 | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,454.40 / $19,498.45
| Facility | | $6,456.54 | $14,454.40 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $446.68 / $501.19
| Facility | | $426.58 | $446.68 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $630.96 / $741.31
| Facility | | $436.52 | $630.96 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,762.47 / $10,964.78
| Facility | | $3,235.94 | $7,762.47 | $10,964.78 |