- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,925.71 / $9,457.27 / $20,928.72
| Facility | | $2,925.71 | $9,457.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,758.22 / $2,925.70 / $9,732.95
| Facility | 50 | $2,758.22 | $2,925.70 | $9,732.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,593.13 / $9,907.12 / $19,318.16
| Facility | | $7,593.13 | $9,907.12 | $19,318.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,539.00 / $1,539.00 / $1,539.00
| Facility | | $1,539.00 | $1,539.00 | $1,539.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $424.75 / $1,323.00 / $6,451.00
| Facility | | $424.75 | $1,323.00 | $6,451.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.30 / $1,539.00 / $1,949.40
| Facility | | $852.30 | $1,539.00 | $1,949.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |