- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $3,090.30 / $9,549.93
| Facility | | $380.19 | $3,090.30 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $660.69 / $2,951.21 / $13,182.57
| Facility | 50 | $660.69 | $2,951.21 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,890.45 / $10,471.29
| Facility | | $1,513.56 | $3,890.45 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $169.82 / $575.44
| Facility | | $81.28 | $169.82 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $1,174.90 / $3,630.78
| Facility | | $288.40 | $1,174.90 | $3,630.78 |