- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,758.22 / $8,477.27 / $20,928.72
| Facility | | $2,758.22 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,779.42 / $3,779.42 / $3,779.42
| Facility | 50 | $3,779.42 | $3,779.42 | $3,779.42 |
- 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
- $196.73 / $604.83 / $2,538.00
| Facility | | $196.73 | $604.83 | $2,538.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.94 / $553.66 / $864.62
| Facility | | $378.94 | $553.66 | $864.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |