- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $3,311.31 / $7,943.28
| Facility | | $478.63 | $3,311.31 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,623.41 / $6,760.83 / $7,413.10
| Facility | 50 | $5,623.41 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $5,495.41 / $13,182.57
| Facility | | $3,090.30 | $5,495.41 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,495.41 / $9,772.37 / $25,118.86
| Facility | 50 | $5,495.41 | $9,772.37 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,698.24 / $3,981.07
| Facility | | $1,202.26 | $1,698.24 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,621.81 / $3,162.28
| Facility | | $1,288.25 | $1,621.81 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $933.25 / $5,623.41
| Facility | | $549.54 | $933.25 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,905.46 / $3,981.07 / $5,888.44
| Facility | 50 | $1,905.46 | $3,981.07 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $8,912.51
| Facility | | $2,884.03 | $5,248.07 | $8,912.51 |