- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,261.08 / $4,474.00 / $9,066.76
| Facility | | $1,261.08 | $4,474.00 | $9,066.76 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,739.47 / $5,865.50 / $9,733.16
| Facility | 50 | $4,739.47 | $5,865.50 | $9,733.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,302.10 / $5,196.00 / $10,517.23
| Facility | | $3,302.10 | $5,196.00 | $10,517.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $848.00 / $1,036.34 / $2,017.56
| Facility | | $848.00 | $1,036.34 | $2,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.50 / $9,332.00
| Facility | | $2,155.00 | $4,983.50 | $9,332.00 |