- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.51 / $4,792.42 / $5,633.07
| Facility | | $585.51 | $4,792.42 | $5,633.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,674.27 / $6,723.76 / $9,653.20
| Facility | 50 | $3,674.27 | $6,723.76 | $9,653.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,652.17 / $5,422.26 / $7,346.31
| Facility | | $4,652.17 | $5,422.26 | $7,346.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,506.41 / $3,777.95 / $4,783.26
| Facility | 50 | $2,506.41 | $3,777.95 | $4,783.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.65 / $4,933.00 / $5,633.07
| Facility | | $608.65 | $4,933.00 | $5,633.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,674.27 / $6,505.14 / $9,653.20
| Facility | 50 | $3,674.27 | $6,505.14 | $9,653.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,450.00 / $5,708.00 / $8,884.00
| Facility | | $1,450.00 | $5,708.00 | $8,884.00 |