- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $977.24 / $2,818.38
| Facility | | $616.60 | $977.24 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,041.74 / $4,786.30 / $12,022.64
| Facility | 50 | $2,041.74 | $4,786.30 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,801.89 / $8,511.38
| Facility | | $1,995.26 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $501.19 / $660.69
| Facility | | $407.38 | $501.19 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $2,290.87
| Facility | | $758.58 | $758.58 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |