- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,621.81 / $6,606.93
| Facility | | $467.74 | $1,621.81 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,737.80 / $2,818.38
| Facility | | $1,122.02 | $1,737.80 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Facility | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $478.63 / $1,659.59
| Facility | | $338.84 | $478.63 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Facility | 54 | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $616.60 / $1,659.59
| Facility | | $138.04 | $616.60 | $1,659.59 |