- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.52 / $2,877.00 / $9,355.17
| Facility | | $682.52 | $2,877.00 | $9,355.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,098.68 / $38,577.67 / $52,266.61
| Facility | | $33,098.68 | $38,577.67 | $52,266.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $17,832.33 / $24,200.28 / $35,438.15
| Facility | 50 | $17,832.33 | $24,200.28 | $35,438.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565.75 / $2,877.00 / $4,933.00
| Facility | | $565.75 | $2,877.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,982.00 / $11,869.00 / $17,263.00
| Facility | | $4,982.00 | $11,869.00 | $17,263.00 |