- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,791.58 / $14,795.41 / $23,478.71
| Facility | | $1,791.58 | $14,795.41 | $23,478.71 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $31,326.21 / $31,326.21 / $31,326.21
| Facility | 50 | $31,326.21 | $31,326.21 | $31,326.21 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $895.79 / $895.79 / $895.79
| Facility | 52 | $895.79 | $895.79 | $895.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,259.71 / $11,976.19 / $16,314.86
| Facility | | $10,259.71 | $11,976.19 | $16,314.86 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,536.11 / $7,554.04 / $10,622.78
| Facility | 50 | $5,536.11 | $7,554.04 | $10,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,791.58 / $14,795.41 / $23,478.71
| Facility | | $1,791.58 | $14,795.41 | $23,478.71 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $31,326.21 / $31,326.21 / $31,326.21
| Facility | 50 | $31,326.21 | $31,326.21 | $31,326.21 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $895.79 / $895.79 / $895.79
| Facility | 52 | $895.79 | $895.79 | $895.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,524.00 / $5,819.00 / $8,339.00
| Facility | | $2,524.00 | $5,819.00 | $8,339.00 |