- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $623.27 / $5,886.88 / $9,701.48
| Facility | | $623.27 | $5,886.88 | $9,701.48 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,976.07 / $11,060.15 / $11,060.15
| Facility | 50 | $2,976.07 | $11,060.15 | $11,060.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,960.45 / $6,745.16 / $15,840.12
| Facility | | $4,960.45 | $6,745.16 | $15,840.12 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,856.74 / $4,114.95 / $5,135.99
| Facility | 50 | $2,856.74 | $4,114.95 | $5,135.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.66 / $6,400.81 / $9,175.32
| Facility | | $494.66 | $6,400.81 | $9,175.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,976.07 / $11,060.15 / $11,060.15
| Facility | 50 | $2,976.07 | $11,060.15 | $11,060.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,500.00 / $8,847.00 / $10,652.00
| Facility | | $4,500.00 | $8,847.00 | $10,652.00 |