- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.66 / $5,515.65 / $12,957.20
| Facility | | $615.66 | $5,515.65 | $12,957.20 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,034.80 / $6,955.02 / $6,955.02
| Facility | 50 | $4,034.80 | $6,955.02 | $6,955.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,888.00 / $5,559.14 / $10,089.79
| Facility | | $1,888.00 | $5,559.14 | $10,089.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,208.42 / $3,208.42 / $4,122.88
| Facility | | $3,208.42 | $3,208.42 | $4,122.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.29 / $545.79 / $932.85
| Facility | | $404.29 | $545.79 | $932.85 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $751.50 / $809.03 / $1,399.28
| Facility | 50 | $751.50 | $809.03 | $1,399.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |