- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.64 / $403.35 / $1,064.08
| Facility | | $287.64 | $403.35 | $1,064.08 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $251.19 / $275.02 / $437.84
| Facility | 54 | $251.19 | $275.02 | $437.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.05 / $413.41 / $450.41
| Facility | | $372.05 | $413.41 | $450.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.58 / $596.58 / $596.58
| Facility | | $596.58 | $596.58 | $596.58 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $417.61 / $417.61 / $417.61
| Facility | 54 | $417.61 | $417.61 | $417.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.83 / $454.83 / $508.99
| Facility | | $454.83 | $454.83 | $508.99 |