- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $5,370.32 / $8,912.51
| Facility | | $602.56 | $5,370.32 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,905.46 / $1,905.46 / $1,905.46
| Facility | 50 | $1,905.46 | $1,905.46 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $9,549.93 / $17,378.01
| Facility | | $4,570.88 | $9,549.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $5,623.41
| Facility | | $794.33 | $794.33 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $812.83 / $2,454.71
| Professional | | $562.34 | $812.83 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $8,128.31 / $15,848.93
| Facility | | $3,235.94 | $8,128.31 | $15,848.93 |