- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $4,365.16 / $10,715.19
| Facility | | $616.60 | $4,365.16 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,548.13 / $7,943.28 / $16,218.10
| Facility | 50 | $3,548.13 | $7,943.28 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,456.54 / $13,803.84
| Facility | | $2,570.40 | $6,456.54 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,047.13 / $2,818.38
| Facility | | $524.81 | $1,047.13 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,623.41 / $12,302.69
| Facility | | $1,995.26 | $5,623.41 | $12,302.69 |