- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.29 / $4,112.00 / $5,918.86
| Facility | | $416.29 | $4,112.00 | $5,918.86 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,650.63 / $7,650.63 / $7,650.63
| Facility | 50 | $7,650.63 | $7,650.63 | $7,650.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,785.75 / $5,586.42 / $7,610.23
| Facility | | $4,785.75 | $5,586.42 | $7,610.23 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,227.97 / $3,523.66 / $5,159.93
| Facility | 50 | $3,227.97 | $3,523.66 | $5,159.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.09 / $4,112.00 / $5,772.72
| Facility | | $333.09 | $4,112.00 | $5,772.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,862.75 / $7,650.63 / $7,650.63
| Facility | 50 | $4,862.75 | $7,650.63 | $7,650.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,296.00 / $7,849.00 / $9,202.00
| Facility | | $3,296.00 | $7,849.00 | $9,202.00 |