- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,689.86 / $7,119.04 / $19,276.96
| Facility | | $2,689.86 | $7,119.04 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,030.90 / $9,030.90 / $9,211.52
| Facility | 50 | $9,030.90 | $9,030.90 | $9,211.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,998.88 / $6,774.77 / $12,717.97
| Facility | | $4,998.88 | $6,774.77 | $12,717.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.00 / $573.04 / $8,632.00
| Facility | | $326.00 | $573.04 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.63 / $814.91 / $3,145.09
| Facility | | $611.63 | $814.91 | $3,145.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |