- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $4,897.79 / $11,481.54
| Facility | | $616.60 | $4,897.79 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,677.35 / $8,128.31 / $14,791.08
| Facility | 50 | $4,677.35 | $8,128.31 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $7,585.78 / $14,791.08
| Facility | | $2,691.53 | $7,585.78 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,023.29 / $2,344.23
| Facility | | $512.86 | $1,023.29 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,168.69 / $9,549.93
| Facility | | $1,513.56 | $4,168.69 | $9,549.93 |