- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,691.53 / $8,511.38
| Facility | | $467.74 | $2,691.53 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,412.54 / $3,981.07 / $7,585.78
| Facility | 50 | $1,412.54 | $3,981.07 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $5,495.41 / $12,022.64
| Facility | | $2,290.87 | $5,495.41 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $1,230.27 / $4,168.69
| Facility | | $93.33 | $1,230.27 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,884.03 / $6,456.54
| Facility | | $1,023.29 | $2,884.03 | $6,456.54 |