- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.40 / $3,094.70 / $8,545.68
| Facility | | $553.40 | $3,094.70 | $8,545.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,856.73 / $5,244.33 / $12,315.62
| Facility | | $3,856.73 | $5,244.33 | $12,315.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,092.42 / $3,199.35 / $4,158.27
| Facility | 50 | $2,092.42 | $3,199.35 | $4,158.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.30 / $3,094.70 / $8,545.68
| Facility | | $464.30 | $3,094.70 | $8,545.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,296.00 / $7,849.00 / $9,202.00
| Facility | | $3,296.00 | $7,849.00 | $9,202.00 |