- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $7,413.10 / $31,622.78
| Facility | | $562.34 | $7,413.10 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $14,454.40 / $14,454.40 / $23,442.29
| Facility | 50 | $14,454.40 | $14,454.40 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $3,162.28 / $3,162.28
| Facility | | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $7,585.78 / $58,884.37
| Facility | | $2,089.30 | $7,585.78 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,165.95 / $6,165.95 / $12,882.50
| Facility | 50 | $6,165.95 | $6,165.95 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $1,905.46 / $2,754.23
| Facility | | $1,905.46 | $1,905.46 | $2,754.23 |