- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,011.68 / $7,853.40 / $12,989.36
| Facility | | $2,011.68 | $7,853.40 | $12,989.36 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $12,854.70 / $12,854.70 / $12,854.70
| Facility | 50 | $12,854.70 | $12,854.70 | $12,854.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.16 / $1,059.49 / $1,791.92
| Facility | | $655.16 | $1,059.49 | $1,791.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,236.68 / $7,779.36 / $11,812.34
| Facility | | $6,236.68 | $7,779.36 | $11,812.34 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,263.73 / $11,669.04 / $17,718.50
| Facility | 50 | $9,263.73 | $11,669.04 | $17,718.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,360.00 / $16,762.00 / $17,870.00
| Facility | | $9,360.00 | $16,762.00 | $17,870.00 |